Gospel Jubilee Cruise Online Registration
*
Contact Name
*
Address
*
City
*
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
*
Zip
*
Home Phone
*
Cell Phone
*
Email
Provide ONLY your first and last name as it appears on your passport.
Legal Name
Date Of Birth (mm/dd/yyyy)
First Passenger
Second Passenger
Third Passenger
Fourth Passenger
Comments, Special Requests, and Special Needs
(bringing wheel chair or scooter, CPAP, insulin,
medicine requiring refrigeration, other)
PAYMENTS & CATEGORY SELECTION
*
SELECT YOUR CABIN CATEGORY
Category 4B
Category 4C
Category 6B
Category 8B
Category 8C
*
PAYMENT PLAN OPTIONS
Pay $250 per person deposit only
Pay 1/2 of cruise cost
Pay In Full
All prices are quoted per passenger based on double occupancy. Call 800-993-8785 for questions regarding rates for children, third and fourth adults in a cabin, single occupancy rates and wheelchair accessible cabins. Suites available upon request.
*
HOST GROUP
Credit Card Information
If possible, the preferred method of payment is by check, money order, or cashiers check.
*
Card Type
VISA
Mastercard
Discover
*
Name On Card
*
Card Number
*
Exp. Month
*
Exp. Year
*
Billing ZIP CODE
*
Indicates Response Required