The Land of the Holy One Registration
Preferred Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email
*
example@example.com
Student Info
If you are a current LCU student who is wanting to attend the 2024 Israel trip for academic credit, please select which class you are enrolled or enrolling for and which semester. Thank you.
Which class are you enrolled for or will be enrolling for?
Please Select
BIB 3152.01- Special Topics: Archaeology of Egypt, Israel, and Jordan
BIB 3352.01- Special Topics: Biblical Archaeology
BIB 6313.01- Biblical Archaeology
Which semester are you enrolling in?
Please Select
Spring 2024
Summer 2024
Passport Info
Name on Passport
*
First Name
Middle Name
Last Name
Passport Number old
Passport Number
*
Country of Issue
*
Passport Expiration Date
*
-
Month
-
Day
Year
Date
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Emergency Contact
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Lodging
I want a single room
*
Yes ($1200)
No
I need a roommate
*
Yes
No
I want to room with
*
First Name
Last Name
Submission
Sign and click submit
Signature
*
Submit
cost
final cost
Should be Empty: