Interfaith Teen Leaders Application
Form Name
Memo
Notes to internal Federation professionals
Applicant Information
Name
*
First Name
Last Name
Email
*
Confirmation Email
Confirm email address
Mobile Phone
*
Format: (000) 000-0000.
Address
*
Street Address 1
Street Address 2
City
State / Province
Postal / Zip Code
Date of Birth
-
Month
-
Day
Year
Grade in the 2026-2027 school year
*
Name of School
*
Which house of worship are you affiliated with, if any?
*
If none, put N/A
In a few sentences, please tell us why you are interested in participating in the Interfaith Teen Leadership program. Feel free to share any personal experiences or specific goals that have motivated you to apply for this program.
Name of person who referred you
First Name
Last Name
Referrer's Email Address
example@example.com
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Parent Information
Parent / Guardian #1 Name
*
First Name
Last Name
Parent / Guardian #1 Email
*
example@example.com
Parent / Guardian #1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent / Guardian #2 Name
First Name
Last Name
Parent / Guardian #2 Email
example@example.com
Parent / Guardian #2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please attach a photo.
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The Interfaith Teen Leader program has a small program fee of $180 to help cover costs. Partial and full scholarships are available. Would you like scholarship information?
*
Yes
No
I understand that my picture may be taken during this program and it may appear on various channels, including social media and the Federation website.
SUBMIT
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