Registration

Please fill out the following form in its entirety. For deposit instructions, see below.

Personal Information (as it appears on your passport)

Title

First Name

Middle Name

Last Name

Passport Number

Nationality

Birth Date




Current Contact information

Email Address (required)

Phone Number

Street Address

Address Line 2

City

State

Zip Code




Emergency Contact information

Full Name

Phone Number

Street Address

Address Line 2

City

State

Zip Code




Other Tour Information

I will make my $150 deposit: By CheckOnline

I would like single room occupancy (additional cost): YesNo

How did you hear about this tour?

What do you want to experience on this pilgrimage?



 

Deposit Instructions

If you wish you make your payments online, please make them here. We have already added the 3% to the total for online payments. Click here for more information on pricing. 


Payment Options

 

If you wish to pay by check please make payable to Jacke Schroeder and send it to:

 Jacke Schroeder

2731 Westminster Rd.

Ellicott City, MD 21043

 

 

Praises

Jacke Schroeder is gifted, intuitive, a concept thinker, and a rainmaker.  She conveys change by living it and speaking it.
Nancy Mills, Founder, The Spirited Woman