HR Mission Application Form
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1. Reservation
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Please reserve:
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space(s) on the mission. A deposit of $500 minimum per person is required.
HonestReporting reserves the right to limit participation based upon eligibility requirements and availability. For further information contact our HonestReporting office in Israel:
U.S. line: 1-847-745-8284;
Non-U.S. line: (011) 972-54-239-2574
*** (Israel time - 7 hours ahead of NY time)
Email: hrmission@honestreporting.com
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2. General Information
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Participant 1
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Title:
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If other, please specify:
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* Full name exactly as shown on passport: *
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* Name as you'd like it on name tag: *
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Gender:
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Nationality:
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Country of Birth:
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Date of Birth:
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Passport Number:
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Country of Issue for Passport:
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Passport Expiration Date:
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If you have month and year only, enter 01 in day.
Please note that your passport must be valid for 3 months from the date of your return to the U.S.A.
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Business Information:
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Occupation:
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Name of Business/Company:
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Participant 2
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Title:
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If other, please specify:
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* Full name exactly as shown on passport: *
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* Name as you'd like it on name tag: *
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Gender:
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Nationality:
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Country of Birth:
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Date of Birth:
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Passport Number:
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Country of Issue for Passport:
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Passport Expiration Date:
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If you have month and year only, enter 01 in day.
Please note that your passport must be valid for 3 months from the date of your return to the U.S.A.
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Business Information:
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Occupation:
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Name of Business/Company:
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Help us to help you!
We want to help you get the most out of your trip with us, so go ahead and help us get to know you. Of course, your privacy is paramount.
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Participant 1
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Important Medical Information
(Handicaps, allergies, medications, or medical condition that we should be aware of):
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Walks of approx 45 minutes and climbing steps are typically part of our program (please see 'Terms and Conditions' for more information).
Please let us know if there is any reason why you will not be able to partake in this part of the program:
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Religious Affiliation (Please select one)
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If other, please specify which:
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Have you been to Israel before?
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If you answered yes to the above, have you attended a Mission in the past?
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If so, please state which:
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Please describe your communal involvement (if any), and the charities you are involved with or that you care about:
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Please tell us why you have chosen to join this Mission:
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Participant 2
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Important Medical Information
(Handicaps, allergies, medications, or medical condition that we should be aware of):
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Walks of approx 45 minutes and climbing steps are typically part of our program (please see 'Terms and Conditions' for more information).
Please let us know if there is any reason why you will not be able to partake in this part of the program:
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Religious Affiliation (Please select one)
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If other, please specify which:
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Have you been to Israel before?
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If you answered yes to the above, have you attended a Mission in the past?
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If so, please state which:
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Please describe your communal involvement (if any), and the charities you are involved with or that you care about:
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Please tell us why you have chosen to join this Mission:
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3. Contact Information
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Address: *
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City: *
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State:
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Postal Code: *
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Country:
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Home Telephone: *
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Work Telephone:
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Cellphone:
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Email *
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4. Emergency Contact
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Name:
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Relationship:
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Place of Work:
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Title:
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Address:
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Telephone:
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Cellphone:
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Email:
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Emergency Contact 2
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Name:
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Relationship:
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Place of Work:
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Title:
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Address:
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Telephone:
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Cellphone:
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Email:
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5. Booking Requirements
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Number of Rooms Required
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Please select which type of room you would like to book:
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Double Superior room - Share with
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If checked above - enter roommate Name:
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/Please try to find me a roommate (see Note below)
Note: HonestReporting will attempt to find suitable roommates, if requested.
However, if we are unsuccessful, participant will be subject to the single supplement charge.
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Other room options available:
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Single Superior room (additional charge of $795 for duration of Mission)
Upgrade to Old City View ($40 per night)
Upgrade to variety of suites (prices upon request)
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Special Requirements:
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Special Dietary Requirements:
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Physical Limitations or Restrictions:
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6. Payment
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I will be sending my payment by:
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Please send your deposit of $500 per person as soon as possible.
Click our HR Donation page to pay your deposit online with a credit card.
If you choose to pay online, please click the 'Other Payment Amount' option and enter $500 (per person), then continue normally.
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Any other comments/requests:
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Your health and security is a priority for HonestReporting. Please forward us a copy of your medical/travel insurance policy, together with a
current passport-sized photograph, for our records, at least 21 days before the start of travelling to Israel. *
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I/We take responsibility for sufficient medical coverage for the duration of my/our stay in Israel.
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