JLIC Ben Gurion University India

Bookings

Ticket Type	Price	Spaces
Standard Ticket	₪3,000.00
Attendee 1 Name * Attendee #NUM# Name *

Name *

Email *

Address *

City/Town *

State/County *

Zip/Post Code *

Country *

Phone

Fax

Date of Birth *

School Name *

Graduation Year *

Who to room with (4 names)

Notes

Legal Name *

Passport Number *

Passport Expiration Date *

General medical info *

Allergies

Food Restrictions

Anything we should know for this event

Parent / Guardian Name *

Parent / Guardian Email *

Parent / Guardian Phone *

Emergency Contact Name *

Emergency Contact Email *

Emergency Contact Phone *

x Standard Ticket

₪3,000.00

Total Price

₪3,000.00 Taxes included

One Time Payment Split Payment

Coupon Code