“...first rate in every respect.”
   – Norman Lipoff, Past Chairman UJA


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NSW Jewish Board of Deputies & HonestReporting Advocates Mission in Israel Application Form


1. Reservation

Please reserve:
space(s) on the mission. A deposit of $500 minimum per person is required.

The NSW Jewish Board of Deputies and HonestReporting reserve the right to limit participation based upon eligibility requirements and availability. For further information contact our office:

Lynda Ben-Menashe, NGO Relations Manager
Phone: (02) 9360 1600
Fax: (02) 9331 4712
Email: benmenashe@nswjbd.com

2. General Information

Participant 1

Title:
If other, please specify:
* Full name exactly as shown on passport: *
* Name as you'd like it on name tag: *
Gender:
Nationality:
Country of Birth:
Date of Birth:

MM
/
DD
/
YYYY
Passport Number:
Country of Issue for Passport:
Passport Expiration Date:

MM
/
DD
/
YYYY

If you have month and year only, enter 01 in day.

Please note that your passport must be valid for 3 months from the date of your return to Australia.

Participant 2

Title:
If other, please specify:
* Full name exactly as shown on passport: *
* Name as you'd like it on name tag: *
Gender:
Nationality:
Country of Birth:
Date of Birth:

MM
/
DD
/
YYYY
Passport Number:
Country of Issue for Passport:
Passport Expiration Date:

MM
/
DD
/
YYYY

If you have month and year only, enter 01 in day.

Please note that your passport must be valid for 3 months from the date of your return to Australia.

Help us to help you!
We want to help you get the most out of your trip with us, so go ahead and help us get to know you. Of course, your privacy is paramount.

Participant 1

Important Medical Information
(Handicaps, allergies, medications, or medical condition that we should be aware of):
Walks of approximately 45 minutes and climbing steps are typically part of our program (please see 'Terms and Conditions' for more information). Please let us know if there is any reason why you will not be able to partake in this part of the program:
Have you been to Israel before?
If you answered yes to the above, have you attended any type of Mission in the past?
If so, please state which:
Please tell us why you have chosen to join this Mission:

Participant 2

Important Medical Information
(Handicaps, allergies, medications, or medical condition that we should be aware of):
Walks of approximately 45 minutes and climbing steps are typically part of our program (please see 'Terms and Conditions' for more information). Please let us know if there is any reason why you will not be able to partake in this part of the program:
Have you been to Israel before?
If you answered yes to the above, have you attended any type of Mission in the past?
If so, please state which:
Please tell us why you have chosen to join this Mission:

3. Contact Information

Address: *
City: *
State:
Postal Code: *
Country:
Home Telephone: *
Work Telephone:
Mobile:
Email *

4. Emergency Contact

Name:
Relationship:
Place of Work:
Title:
Address:
Telephone:
Mobile:
Email:

Emergency Contact 2

Name:
Relationship:
Place of Work:
Title:
Address:
Telephone:
Mobile:
Email:

5. Booking Requirements

Number of Rooms Required
Please select which type of room you would like to book:
 Double Superior room - Share with 
If checked above - enter roommate Name:
/please try to find me a roommate*

Note: We will attempt to find suitable roommates, if requested.
However, if we are unsuccessful, participant will be subject to the single supplement charge.
Other room options available:
 Single Superior room (additional charge of $720 for duration of Mission) 
 Upgrade to Old City View ($135 per night) 
 Upgrade to variety of suites (prices upon request) 
Special Requirements:
Special Dietary Requirements:
Physical Limitations or Restrictions:

6. Payment

Because of laws in Australia relating to travel arrangements, all payments must be made to our appointed licensed travel agent: Travelbookers.com Pty Ltd, license number 2TA4949 Travelbookers.com.au Tel: 9440 1455. While your Mission fee must be paid to Travelbookers.com Pty Ltd, it is your decision whether you use Travelbookers to book your actual airline tickets or not.

Please select the payment method for your Mission fee. This can be made by cheque, MasterCard or Visa.

I will be sending my payment by:

If you are paying by Mastercard or Visa, click the NSW Jewish Board of Deputies registration page.

When you return your application Travelbookers.com Pty Ltd will charge your credit card an initial deposit of $500 per person. Where payment is to be made by cheque an initial payment of $500 per person is to accompany the application. Within 14 days after Travelbookers.com Pty Ltd provides the NSW Jewish Board of Deputies with a copy of your application and confirmation of receipt of your deposit, you will be notified whether you have been accepted as a participant. If you are not accepted, your deposit will then be returned. Sixty (60) days before the start of the Advocates Mission, Travelbookers.com Pty Ltd will charge your nominated credit 50% of the balance of the total fee for the Advocates Mission. Thirty (30) days before the start of the Advocates Mission, Travelbookers.com Pty Ltd will charge your nominated credit the balance of the total fee for the Advocates Mission. If you wish to pay by cheque, payments must be made to the travel agent in accordance with the schedule detailed above. Your payment should be sent directly to the travel agent.

Your health and security is a priority for us. Please forward the NSW JBD a copy of your medical/travel insurance policy, together with a current passport-sized photograph, for our records, at least 21 days before the start of travelling to Israel. Forward them to Level 2, 146 Darlinghurst Rd, Darlinghurst NSW 2010 *
 I/We take responsibility for sufficient medical coverage for the duration of my/our stay in Israel. 
 I have read and accepted the Terms and Conditions