Please use the form below to place your $1,500 deposit to hold your spot for the April 19 to 23 Seattle Leadership Mission to Israel.

The total cost of the trip is estimated not to exceed $5,000 for single occupancy and $4,000 for double. The balance of the cost will be due closer to the trip start date. This cost will include four nights of hotels, all meals, touring and program, security, and gratuity for Israeli tour guides and drivers. The cost does not include airfare. We strongly encourage participants to purchase trip insurance. If the trip is unable to take place, your deposit will be fully refunded.

If you have any questions, please contact Tori Schwartz at ToriS@jewishinseattle.org.

Your Info

First Name

Middle Name

If you do not have a middle name, type "N/A".

Last Name

Name for Name Tag

Please provide the full name you would like included on your trip name tag.

Occupancy

SingleDouble

Name of Co-Occupant

Please note: They will need to register separately.

Passport #

Passport Expiration Date

Email Type

Mobile Phone

Phone Type

Birthdate

Please include any dietary restrictions/allergies we should be aware of below:

Please include any access requirements/physical disabilities we should be aware of below:

Payment Info

Deposit Amount Due

You will be charged this amount when you click "Register" below.

Please check this box if you are paying with an American Express card.

Cardholder Name

Card Number

Expiration Month

Expiration Year

CVV

Billing Street

Billing City

Billing State

Billing Zip Code

Billing Country

Address Type

Hidden Fields

Campaign ID

Campaign Name

CVV Input

Default Address

Active Address