Women's Mission to Israel FY26

MC tag
Appeal code
Memo
For internal use only
Registration

For the best user experience we recommend completing this form using a computer.
PARTICIPANT INFORMATION
Name

First NameLast Name
E-mail

Confirmation Emailexample@example.com
Birth Date

MonthDayYear
Date
Mobile Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Name (as it appears on your passport)

First NameMiddle NameLast NameSuffix
Passport #
Expiration Date

MonthDayYear
NOTE: Passports must be valid for at least six months beyond the return date of the mission
Please inform us below of any allergies you have.
Please enter "none" if not applicable
Please inform us below of any health or medical concerns of which we should be aware.
Please enter "none" if not applicable
Please inform us below of any dietary requirements (gluten-free, vegetarian, Kosher, etc.) of which we should be aware.
Please enter "none" if not applicable
Please check the size of sweatshirt you would like
PAYMENT AND TRIP COST

Options

$500 deposit, per person, due today (fees apply)

$500 per person, is due by August 15, 2025. Select your preferred method of payment for the remaining balance below. (Note: the $500 deposit is refundable until September 12, 2025.)

$500.00 Payment options:

Optional add-ons

*Single Supplement — 675

If you prefer a single room, without a roommate, please select this option.

$675.00 Payment options:

Pledge your gift to the 2026 UJA Annual Campaign

This mission welcomes individuals and/or households who make a minimum gift of $10,000 to the 2026 UJA Annual Campaign. Your annual gift supports Federation’s lifesaving work around the globe and at home in New Jersey. Pledges to the 2026 UJA Annual Campaign are payable through December 31, 2026.

$1.00 Amount $Payment options:
Item subtotal:

Enter coupon

Subtotal

Tax

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

TRAVEL AND ACCOMMODATIONS
Designated Flights:

Newark, NJ to Tel Aviv, Israel departing on Sunday, November 9, 2025
El Al #LY28 — Newark (EWR) • 9 NOV 1:15 PM ✈ 6:35 AM 10 NOV • Ben Gurion (TLV)

Tel Aviv, Israel to Newark, NJ departing on Friday, November 14, 2025
El Al #LY27 Ben Gurion (TLV) • 14 NOV 1 AM ✈ 6 AM. 14 NOV • Newark (EWR)
Participants are responsible for coordinating and booking their own flights. Please select one of the following options:

Please share your flight information below.

Rows	Airline and Flight #	Date	Departure Time	Arrival Time
Outbound Flight
Return Flight

Roommate (select one)
Please indicate the name of your preferred roommate

First NameLast Name
Bed type with preferred roommate
EMERGENCY CONTACT INFORMATION

Do not include someone who is on the trip with you
Emergency Contact

First NameLast Name
Relationship
Mobile Number
Format: (000) 000-0000.
SIGNATURE AND AGREEMENTS

IMPORTANT: Must be completed for each participant included in this registration
Name

First NameLast Name
Date

MonthDayYear
Date
Signature
Your signature above confirms you have read and understand the release forms and information below.
paymentData
Should be Empty:

Registration

PARTICIPANT INFORMATION

PAYMENT AND TRIP COST

Options

TRAVEL AND ACCOMMODATIONS

EMERGENCY CONTACT INFORMATION

SIGNATURE AND AGREEMENTS