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GESHARIM | Israel Trip 5784 Deposit payment
RSY-Netzer
6
Questions
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1
Please continue with this very short form to pay the deposit
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2
Your Name
*
This field is required.
Parent/guardian
First Name
Last Name
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3
Your Email address
*
This field is required.
The same address given on Initial Application form
example@example.com
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4
Child's Name
*
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5
Financial Assistance?
We offer means-tested financial assistance in conjunction with UJIA. If you require financial assistance, please use the tick the financial assistance box and choose the reduced deposit option on the next screen - you will then be required to submit another form with financial information to assess your application.
I would like financial assistance
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6
Payment
*
This field is required.
Pick the correct deposit type for your situation
. You can also support us further by
covering our processing fees
If you are fortunate enough to be able to support others, we would
welcome a donation
to the financial assistance fund. Don't forget to
Gift Aid
if you can!
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ORDER SUMMARY
Total cost
GBP
Israel Trip 5784 Deposit
Full deposit
£
500.00
+
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Israel Trip 5784 Reduced Deposit
ONLY to be used for those choosing financial assistance and if you cannot pay the full deposit
£
100.00
+
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(Optional) Cover processing fees
Help us to cover our payment provider processing costs
£
6.00
+
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Donation £10
£
10.00
+
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Donation £20
£
20.00
+
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Donation £50
£
50.00
+
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Donation £100
£
100.00
+
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First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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7
Gift Aid
Don’t forget to GiftAid your donation. If you are a UK taxpayer, you can boost your donation by 25p of Gift Aid for every £1 you donate. Please tick the box below.
I agree to Gift Aid this donation. I am a UK taxpayer. Please treat my donation and any donations I make in future or have made in the past 4 years to The Movement for Reform Judaism as Gift Aid donations. I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.
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8
Billing Name
For Gift Aid declaration
First Name
Last Name
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9
Billing Address
For Gift Aid declaration
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Palau
Palestine
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Paraguay
Peru
Philippines
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Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
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Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
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Slovakia
Slovenia
Solomon Islands
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Somaliland
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Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
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Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
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Tristan da Cunha
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Turkmenistan
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Tuvalu
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Uruguay
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Vietnam
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US Virgin Islands
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Yemen
Zambia
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Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
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