Epicenter • Israel Tour • May 15-16, 2011

To create a group within the red tour, you will need to complete the fields below. With this information we will be able to register you for the tour and compile the necessary information for your constituents to be able to start the booking process. Shortly after completing this form you will receive an email from Inspiration Cruises & Tours providing you with access to promotional materials and further instructions for your constituents on how to book a tour within your grouping. This email will also include instructions on how to add a second passenger (spouse) to your personal reservation.

Personal Information
* Legal Name	(as it appears on your passport)
* Title (at church)
* Gender	Male Female
* Marital Status	Married Single
* Birthdate	/ /
* Email
Passport #	Exp. Date / / U.S. Citizen Yes No
Country of Issue

Addresses
* Home Address
* City	* State * Postal Code
* Phone	i.e. 123-456-7890 Alt. Phone Work Mobile
* Church Name
* Church Address
* Church City	* State * Postal Code
* Church Phone	* Church Size
* How many do you expect to come with you on the tour?
* How did you hear about the tour?

Emergency Contact Information
Emergency Contact Name
Relationship
Contact Phone	Alt. Phone Work Mobile

Tour Selection *
11 Day Tour		Conference Only
	May 9-19		May 15-16	Requires providing own travel to event.

International Departure City *
New York (JFK)	Los Angeles (LAX)	Atlanta (ATL)	No Flights Included

Submitting this form notifies us of your intention to attend the conference and bring a group from your church or ministry. We will contact you shortly to confirm details and get you resources to begin promoting this event. Thank you!