Tour Leaders - Dr. Judy and Dallas Phillips
College Credit Available

ISRAEL REGISTRATION FORM

(Photocopy for additional tour members)

REGISTRATION FORM
Israel Study Tour
(Photocopy for additional tour members)

Name (as written on Passport)_____________________________________________

Name desired for Name Tag_______________________________________________ 

Street Address__________________________________________________________ 

City/State_______________________Zip_______Home/Work Phone_____________ 

E-Mail________________________________________________________________

Passport #_________________Place Issued___________________Date Issued______

Expires____________Citizenship________________________Birth Date__________ 

Birthplace__________________________Departure City________________________

Occupation_______________________Roommate Desired______________________

Are you celebrating a special event on the tour? Event_______________ Date______

Deposit of $500 per Person Enclosed__________ Check #_________

I have read the terms and conditions and have agreed to conform to them.

Signed___________________________________________ Date______________

Attach photocopy of front page of Passport.

^{Mail Registration Form and Checks to:}
Dr. Judy Phillips, Glory Quest Tours
P.O. Box 1207, Citrus Heights, CA 95611

For Questions, please contact:
Dr. Judy Phillips, Glory Quest Tours -- DrPhillips@GloryQuests.com 
916/924-1919 or 866/274-4826; Fax:  916/924-1234
P.O. Box 1207, Citrus Heights, CA 95611

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