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
Birth Date*

Month Day Year
School*
Grade entering*
Teen's Email Address
Teen's Phone Number

Address*

Additional notable Information
Parents Information
Father's Name*

First Name Last Name
Father Cell

Area Code Phone Number
Mother's Name*

First Name Last Name
Mother Cell

Area Code Phone Number
Have there been any adoptions or conversions in the family?

Yes No
Please provide more details:
Which programs are you interested in? Check all that apply

Monthly Supper and Study (great food, interesting Jewish discussion, fun activities, and more) Kosher Food Club at your High School Holiday events NYC Shabbaton Cteen U (earn college credits for learning about Judaism) Cteen Summer (Israel+Poland trip or West Coast traveling camp)
Which dates/times work best for you?
Are you interested in transportation to events/programs?

Yes No
Payment
Registration:* $200

Pay in full I 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