JIL ISRAEL TOUR CONGRESS

April 20 26, 2014

REGISTRATION FORM
Pastor

Mr.

Miss

Ms.

JANET P. TOMAS
Passenger Name (as shown in Passport) ______________________________________________________
PHILIPPINES
23 MAY 1970
Date of Birth: ___________________________
Place of Birth: ______________________________
jptireland@yahoo.ie
+353 862109821
Email: __________________________________
Telephone/Mobile: _________________________

74 MERRION RD.BALLSBRIDGE,DUBLIN 4,IRELAND

Home Address: _______________________________________________________________________

___________________________________________________________________________________
PD9829842
08 FEBRUARY 2013
Passport Number: ________________________
Date of Issue: _______________________________
(Your passport must be valid for up to six months after the date you enter Israel)

DUBLIN,IRELAND
07 FEBRUARY 2023
Place of Issue: ____________________________
Date of Expiry: _____________________________
SINGLE
IRISH
Nationality: _____________________________
Status: ___________________________________

Name of Company/School: ____________________________________________________________

Office/School Address: ________________________________________________________________
NANNY
Occupation/Profession: ___________________
Company Tel Number: _______________________
DUBLIN
JIL Chapter/Country: __________________________________________________________________
ROSANNA SESTOSO
Church Pastor: ___________________________
Position Held (if any): ________________________

IN CASE OF EMERGENCY:
JOCELYN BAGSANGTOMAS
Name: ______________________________________________________________________________
,APT.2, 9 SERPENTINE AVE.,BALLSBRIDGE, DUBLIN 4, IRELAND
Address: ____________________________________________________________________________
+353 868508617
FRIEND
Contact Numbers: ________________________
Relationship: ______________________________

FLIGHT DETAILS:
Text
10:20
SK538
Departure (for Israel): ____________
Flight No. _________________

SAT. 18/04
Date: _________________

SK771
04:15
Arrival: _________________________
Flight No. __________________

SUN.19/04
Date: _________________

TERMS OF PAYMENT:
50% downpayment on or before January 30, 2015
50% full payment on or before February 15, 2015

JANET P. TOMAS
______________________________________
Signature of Applicant

13 FEB .2015
___________________________________
Date