TEC On-Line Candidates Application Form

 Please submit the following form to register for your Teens Encounter Christ weekend. The dates of our weekends may be found on the TEC Calendar page.

Please make note that this application will not be considered complete without sending the parental/guardian permission page and the Reference page. These may be printed off of the Applications Page under "Printable Candidate Application Form". They should then be mailed to :

TEC
3209 60th Street
Moline, IL 61265

Today's Date:
Parent/Guardian:
P/G Phone:
Name:
Gender:
Male
Female
Date of Birth:
Phone:
E-Mail:
Address:
City:
State/Zip:
   
School:
School Class:
Sophomore
Junior
Senior
College
Church:
Church City:
Work:
Referred to TEC by:



Date of Weekend (Choose 1):
Girls, Nov 7-9, 2009
Boys, Dec 5-7, 2009
Girls, Jan 16-18, 2010
Boys, Feb 13-15, 2010
Girls, March 6-8, 2010
Boys, April 10-12, 2010
Girls, June 12-14, 2010

List your school activity involvement:


Plans for the immediate future:


List any special dietary needs:


What do you hope to gain from your TEC experience?


  


Return to Main Applications Page


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