Online Candidate Application

Candidates must be 16 years of age or will turn 16 prior to the next TEC weekend.

Candidate Application

* Indicates required field

Candidate Name *

First

Last

Nickname (If applicable) *

Gender *

Male Female

Address *

Line 1

Line 2

City

State

Zip Code

Country

Today's Date *

Date of Birth *

Age on the weekend *

Email *

Phone Number *

School *

Year of Graduation *

Choose One *

Sophomore Junior Senior Other

If teen doesn't attend, parent will be notified. *

Agree Disagree

Church/Parish *

Church/Parish City *

Referred By: *

Referrer's Phone Number *

Mother's Name *

First

Last

Father's Name *

First

Last

Mother's Address *

Line 1

Line 2

City

State

Zip Code

Country

Mother's Email *

Father's Address *

Line 1

Line 2

City

State

Zip Code

Country

Father's Email *

Mother's Phone Number *

Guardian's Name (If not mother/father) *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone *

Father's Phone Number *

What activities have/do you participate in at your school? *

What are your plans for the immediate (next few years) future? *

Please give a brief description of what you expect to gain from this TEC experience. *

Do you have any special needs (medical, physical, etc.)? *

Please List Any Food Allergies or Special Diet *

Submit

Northwest teens encounter christ

Candidate Application