TEC Candidate Online Application

"*" indicates required fields

Weekend Date*

Select the month for the weekend you are attending

Sponsor Contact Information

Your Sponsor should be an adult who knows you well, preferably your youth minister, religion teacher, or pastor/minister. Their input helps us form small groups on the weekend.

Sponsor Name*

First Last

Sponsor Email Address*

Candidate Contact Information

Name*

First Last

Birthday*

Age*

Sex*

Shirt Size*

Address*

Street Address City State ZIP Code

Phone*

Email*

School*

Parish / Church*

Pastor / Minister*

How did you find out about TEC?

Describe any special interests or hobbies

Have you been to any other youth conferences, retreats, or camps?

Describe your participation in your church...

Please name any brothers or sisters who have made TEC

Please share some reasons for attending a TEC weekend at this time.

(No answers are right or wrong, as long as they are honest)

Health Care Information

Please list any Medical Problems / Allergies

Please list any Medications you take

Parent / Guardian

(Please list parents or guardians who should know you are on the TEC weekend)

Parents' Names (1)*

Parents' Address (1) (If different from above)

Street Address City State ZIP Code

Cell Phone (1)*

Email (1)*

Parents' Names (2)

Parents' Address (2) (If different from above)

Street Address City State ZIP Code

Cell Phone (2)

Email (2)

DISCLAIMER: In case of non-attendance to planned weekend, any deposit/payment will be credited to attendance on a future TEC weekend within 12 months.

Please note that it is very important to realize that TEC is a voluntary experience and no one should be required to make a TEC weekend. It is also important to understand that TEC does not encourage the absence of school on the Tuesday following the weekend. Every effort should be made to attend school following a weekend.

Electronic Signature*

Please type your First and Last Name

Agreement*

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above terms.

I agree to allow my child to be treated

Emergency Contact Person (If not parent)

Emergency Contact Phone*

Payment Information

The actual expense for the weekend is over $150 per participant. Thanks to the generosity of many donors to our annual campaign, Great River TEC has been able to reduce the cost for candidates.

Payment*

$50.00 - Ages 16-21

$100.00 - Ages 22+

I have made prior arrangements

Please describe alternate payment arrangements

If you have made prior payment arrangements (such as financial assistance or parish assistance, please provide details here)

Total

This field is for validation purposes and should be left unchanged.