CTeen Registration

CTEEN REGISTRATION
Join us for an exciting and inspiring year in CTeen Naperville! This year we're going big...with more fun, different outings, and lots of time spent with your Jewish friends!
Teen's Name*

First Name Last Name
Hebrew Name
Birth Date*

Month Day Year
School*
Grade entering*
Teen's Email*
Teen's Cell*

Address*

Previous Jewish Education

YesNo
Where
Sweatshirt Size*
Additional notable Information
Parents Information
Father's Name*

First Name Last Name
Father Cell

Area Code Phone Number
Is father Jewish?

YesNo
Mother's Name*

First Name Last Name
Mother Cell

Area Code Phone Number
Is mother Jewish?

YesNo
Have there been any adoptions or conversions in the family?

YesNo
Please provide more details:
Which programs are you interested in? Check all that apply

Kosher Food Club at your High SchoolHoliday eventsNYC ShabbatonCteen Summer (Israel+Poland trip or West Coast traveling camp)Monthly events
Which dates/times work best for you?
Are you interested in transportation to events/programs?

YesNo
Payment
Registration:* $200

Pay in fullI would like to request a scholarship.
This fee enables us to provide quality programming and events for your teens. If needed, there are scholarships available.
Total:

$0.00

Payment

Credit Card Other

Postal / Zip Code

Country

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CTEEN REGISTRATION