REGISTER NOW & PAY DEPOSIT Option 1

No Ordinary Week in Jerusalem + 3 Day Tour with Ruth Fazal

November 5th-15th 2023

Please check the box

I am registering for NOW in Jerusalem + 3 Day

Name #1 *

First

Last

Name #2

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Type of Accommodation *

Single
Single (Shared)
Married Couple (shared)

Name of Roommate if applicable

Passport Name #1 *

Passport Number *

Passport Date of Birth

Passport Country of Issue *

Nationality *

Passport Name #2

Passport Number

Passport Date of Birth

Passport Country of Issue

Nationality

Name of Emergency Contact *

Telephone Number and Relationship of Emergency Contact *

How did you hear about Now in Jerusalem? *

Have you been in Israel before with Ruth and Gil? *

Deposit Information

Cardholder Name *

First

Last

Billing Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Credit Card Number *

Expiry Date *

CSV Number *

Cardholder's Name *

Checkbox Items

I hereby authorize the amount of $500 US to be charged to my card plus a 3% fee.
I hereby authorize the amount of $1,000 US to be charged to my card plus a 3% fee.

Date

Comments or Questions

Your $500 deposit per person is due immediately with your registration.
A credit card fee of $15 will be added when your deposit is processed.
Please allow 48 hours for the processing of your credit card payment. You will receive an email once your payment has been processed.

Pay the remaining amount via bank transfer any time before Sept 19th 2023

Please ensure your remaining payment is sent in US dollars, and that your bank does not pass on the bank fee to us.
All bank fees must be paid by you, until it reaches our bank account.
Banking information:
Bank: Canadian Imperial Bank of Commerce
Bank Branch 09042
Bank # 010
Address: 15195 Yonge Street Aurora ON, L4G3H1 Canada
Name of Account: Tributary Music
Account Address: 296 Glebemount Ave, Toronto, ON M4C 3V3
Swift Code CIBCCATT
Routing code: 001009042
IBAN CC001009042
Account # 0217514 US dollar account

Please contact us at nowinjerusalem@gmail.com if you have any questions about this registration