International Visitor’s Program (IVP) Application Form


Name & Surname *(Your official names as they appear in Passport or National ID)

Email Address *

Nationality *

How old are you? *

Phone number *(Please include your country Code)

Gender *


Are You Local (US)?


Passport Number


Will you need a letter to Apply for U.S. Visa? *


State Reason for your visit*

DeliveranceHealingBreakthroughFinancesMarriageFruit of the Womb

If sick, state your medical condition

State medication your are taking (Please be sure to come with your medication)

Do you need medical certificate to travel*


If yes, send copy to

Tick all medical conditions that apply to you*(Please be honest so we can best prepare for your visit)

I am limpingI am using a CrutchI am using a WheelchairI am paralysed I am blindI have a Mental DisorderI am DeafI have Kidney Failure I am Epileptic/ have EpilepsyI have/had a Stroke/Heart DieaseTB/any other contagious ailment Pregnant 1-7 MonthsPregnant 8-9 MonthsNone of the above

Transport options

By AirBy RoadBy Rail

If By Air, will you need transport

(a) From airport to hotel on arrival


(b) From hotel to airport on departure:


If yes to either question, buy conference ticket with transport service included (see FAQ on transportation)

Arrival Date

Arrival Time

Arrival Airport

Dulles/WashingtonReagan National/WashingtonBaltimore/Washington

Name and Relationship of anyone accompanying you

Names Relationship to you Age

International Visitor Program payment options

$900 (for each person) staying at Gaylord National Resort Hotel (Room shared by 4 people; 2 queen beds)$1200 (for each person) staying at Gaylord National Resort Hotel (Room shared by 2 people (non-spouse); 2 queen beds)$1,800 (for each person) staying at Gaylord National Resort Hotel (VIP Room; 1 King Bed; No Sharing).

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Special Price
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