Jerusalem Fellowships Registrations

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To complete your application and in order to receive an interview, please pay the $50* application fee below

*If deposit payment for the trip is received within 48hrs of acceptance, and payment for the trip is received on-time, then the $50 will be refunded from the cost of your trip.

If you are not accepted to the trip the $50 will be refunded directly to you.

First Name*
Last Name*
Number of Registrations*
Street Address*
City*
Province*
Postal Code*
Phone Number*
Email Address*
Payment Type*	Visa MasterCard
Credit Card Number*
Expiry Date Month*
Expiry Date Year*
Name on Credit Card*
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