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GENERAL INFORMATION
Are you attending the Jerusalem Encounter Conference (+USD $200)
Full Name:
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Preferred name for name tag:
Full Address:(Include Country, State and Postcode)
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Church Name
Telephone:
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Would you like to be baptised for the first time?A USD$10 fee will need to be paid at the baptismal site. It covers towel & robe rental, showers and baptismal certificate.
FLIGHT
Make sure you confirm with Leanne before booking your flights. 

PASSPORT INFORMATION

Please write your name exactly as it appears on your passport:

Name written EXACTLY as it appears on passport:
Expiration Date:Passports MUST have a 6 month validity
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Passport Number:
Date of Birth:
Country of Issue:
Nationality
Copy of Passport(attach a copy of your passport)
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ROOM SHARE INFORMATION
Name and relation of your room mate:
VISA INFORMATION
List any relatives traveling on this tour and their relation to you:
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Your mothers maiden name:
Your father’s name:
Your maternal grandfathers name:
Your occupation:
Month and year of your your last visit to Israel:
List any country you have travelled to in the last 12 months:
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HEALTH & SAFETY INFORMATION
Emergency contactName and number (include international code: )
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Do you have Travel Insurance?
List any medications you are on:
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There will be a lot of walking during this tour - Do you have any walking disabilities? Please explain:
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Please list any allergies, food or otherwise:
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Do you suffer from motion sickness?
Do you have a fear of confined spaces:
Would you like to know more about Middle East?
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Payment Details:

All payments to be made by ITT to our USD account.

Bank: Commonwealth Bank of Australia C/O 48 Martin Place, Sydney NSW 2000 Australia
Swift Code: CTBAAU2S
Account Name: Teach All Nations Inc
Account Number: 06300012661222
Please ensure Customer Reference states your name.

Once your payment has been made please email us to confirm.

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