Registration

Submit your registration now!

Register Here

*Please NoteThe dates of the event are Thursday 8th June 2017 – Monday 12th June 2017 and all prices do not include flights.





First Name*

Last Name*

Email*

Date of Birth*

Mobile Phone*

Current Address of Residence*

Current City of Residence*

Current ZIP Code*

Current Country of Residence*

Country of Birth*

Gender*
 Male Female

Actual Cost Rates – Package without any subsidy

Subsidised Cost Rates / Local Packages – Package with our sponsors discount subsidy

Book extra night?
 Wednesday Sunday

What is your Passport / EU ID Number?*

Would you like to sponsor another less fortunate participant?*
 Yes No

If yes, how much?

Are You Jewish?*
 Yes No

Who was born Jewish?*
 Mother Father Both Neither

Current Religious Orientation?*

What’s your occupation*

Would you be willing to relocate for marriage?
 Yes No

How did you hear about us?
 JEP Newsletter or e-mail ECJS Newsletter or e-mail Facebook Local Student Organization JEP Representative Friends

If JEP Representative, who?

Do you have any food restrictions (e.g. Vegetarian but eat fish, Vegetarian but don’t eat fish, Vegan, Lactose Free)?

Roommate preference for double room package (same gender only):

If you have never been to an ECJS or JEP event, for security purposes, please provide the name and contact information of a Rabbi, Student Organization, Community Leader, friend, etc. that has known you for at least three years.

Organization Name

Contact Person

Email

Position

Telephone

Comments

I hereby acknowledge and agree to the Terms and conditions of JEP

 

Payment Options

Please only pay after you have completed the event registration form.

Bank transfer – If you pay by this please email us a copy of the receipt ticket (info@jep.eu) as we may not see the transfer until the event now starts.

Participant responsible for bank fees. Be sure to write ‘ECJS + JEP Bangkok and Your Full Name’ on the transfer.

  • Account name: ECJS
  • Account Number: 363-1624975-71
  • IBAN: BE 49 3631 6249 7571
  • BIC: BBRUBEBB
  • Bank: ING
  • Branch: Schuman
  • Address: Rond Point R Schuman 8, 1040 Bruxelles, BELGIUM

 

Paypal

Processing fees for using Paypal are added.


Event Packages




Extra Night Options



 

Credit Card

Please fax in the following details to 003222801435 or e-mail it to info@jep.eu . Make sure to write ‘ECJS + JEP Bangkok and your full name’ on the fax or e-mail. Please note that only VISA and MASTERCARD are accepted. Use Paypal for AMEX.

€22 processing fee will be added to the total per person for a double room package, €30 in a single room package and €50 in a suite.

  • Name on card
  • Card number
  • Expiration date
  • Amount to be charged (incl. processing fee)