Gender: MF Title: Mr.Mrs.MissDr.Prof. Family name: First name: Home (or work) address: Home & Cellular phone numbers: E-mail:
Nationality: Passport number:(Please check that your passport is valid until June 2020)
I register for: The conference only (200 Euro)
And:
I register for the 1 day tour to the dead see and Masada (125 Euro) onSunday 1st December 2019Thursday 5th December 2019My accompanying person will join me on the tour and I am paying for him/her.
Accommodation:
Please reserve for me nights in the Ramada Hotel (140 Euro per night)
Please reserve for me nights in the Royal Hotel (90 Euro per night)
Please send me accommodation proposals.
Payment
Please charge my credit cardI'll pay by bank transfer
These are the bank details for the transfer: REGINA TOURS 11, KIRIAT MADA STREET JERUSALEM – ISRAEL BANK LEUMI 208, JAFFA STREET JERUSALEM - ISRAEL BRANCH #904 ACCOUNT #703400/88 SWIFT CODE: LUMIILIT EBAN: IL900109040000070340088
VisaMaster CardAMEX Name of Credit Card Holder: Credit Card Number: Expire Date: 3 back digits of Credit Card: