That's What Teens Say Champaign-Urbana Application

That's What Teens Say

Fall Application 2024

Champaign-Urbana, IL

You are applying to participate in the That's What Teens Say Program!

Someone in your life thinks you would enjoy and be a great contributor to this 3-day weekend program!

Please Only Submit this Application if you are available during:

The weekend of Friday, November 1st - Sunday, November 3rd, 2024
Friday, November 1st, 6:00 PM - 9:00 PM
Saturday, November 2nd, 10:00 AM - 6:00 PM
Sunday, November 3rd, 11:00 AM - 4:00 PM

Please note that this program has a fee of $175.00 for the entire weekend participation including all meals and snacks. Please indicate by checking the statement below if you would like to be considered for financial assistance. Generous scholarships are available through the support of our sponsors. Acceptance to the program will not be influenced by ability to pay.

We're excited that you are planning to join us for the upcoming event, please share the following information below:

Your Name *

Your Phone *

Your Email *

Your Date of Birth *

Your Age *

Your Grade *

Your School *

Your Instagram Handle

Please consider me for one of the sponsor scholarships.

What is your T-shirt size *

I verify that I am available at all of the following dates and times: Your participation is important to us! Please select all that apply: *

Friday 6-9pm

Saturday 10am-6pm

Sunday 11am-4pm

Your Parent or Guardian's Name *

Your Parent or Guardian's Email *

Your Parent or Guardian's Phone Number *

Your Parent or Guardian's Address *

Your Parent or Guardian's City *

Your Parent or Guardian's State *

Your Parent or Guardian's Zip Code *

What makes you happy? Tell us about it in 2-3 sentences. *

Tell us about someone who has had a positive impact on your life (4-6 sentences). Be sure to include how you know the person and what they have done/continue to do that has an impact on your life. *

What is a common misconception people have about you? Something that people assume to be true, but isn’t (4-6 sentences). *

How comfortable are you speaking in front of groups of people? (1=NEVER EVER going to happen in a million years & 10=I LOVE being in front of people - speaking, performing, whatever! *

Contact: (224) 267-9933 | [email protected]