Teen Israel Leadership Council Application

MailChimp Tag (will autofill based on event name)
Teen Israel Leadership Council Information
Name

First NameLast Name
Email

Confirmation Emailexample@example.com
Pronouns
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School
Parent / Guardian Information
Parent / Guardian #1 Name

First NameLast Name
Parent / Guardian #1 Email

Confirmation Emailexample@example.com
Parent / Guardian #1 Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent / Guardian #2 Name

First NameLast Name
Parent / Guardian #2 Email

Confirmation Emailexample@example.com
Parent / Guardian #2 Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

What are your extracurricular activities?
Allergies and any dietary requirement
If none please write N/A
Congregation affiliation, if any (Name and Location)

Congregation NameCongregation Location
I would describe my Jewish practice as:
Please list two references, including name, title, and contact information:
Have you ever been to Israel?
Which three colleges are you interested in applying to?
Are you planning to take a gap year?
Essay

Please write a 750-word essay on one of the following topics:
1. Why I want to be part of TILC.
2. What Israel means to me.
3. Have you or anyone close to you ever experienced an act of antisemitism? How did you respond (or not respond)?
4. You see someone you know in class wearing a t-shirt that reads “Support Human Rights. Free Palestine.” You are friendly with this person but you’ve never talked politics with them. How do you engage?
Upload Essay

Cancelof
Should be Empty:

Teen Israel Leadership Council Information