That's What Teens Say Champaign-Urbana Nominations

That's What Teens Say

Fall Nomination 2024

Champaign-Urbana, IL

Use this form to nominate a girl between the age of 13 - 18 for the That's What Teens Say Weekend Program.

Please submit by Friday, October 25th.

**Nominee would need to be available:

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

**Program has a fee of $175.00 for the entire weekend participation including all meals and snacks. Please indicate if your nominee should be considered for financial assistance, as program scholarships are available to those who need them thanks to our generous sponsors.

Nominee Information: Please tell us about the teen girl you are nominating for the program. We will contact your nominee and parent or guardian once this form is submitted.

Nominee's Name *

Nominee's Phone Number *

Nominee's Email *

Nominee's Age *

Nominee's School

Nominee's Grade

Your Relation To The Nominee *

Length Of Relation To The Nominee *

Visual Estimation Of Nominee's Race/Ethnic Background

I believe my nominee would need a scholarship in order to participate. *

Nominator Information: Please tell us about yourself!

Nominator Name *

Nominator Email *

Nominator Phone *

What is the best way to contact you? *

Nominator Occupation *

Nominator Employer *

Nominator Address *

Nominator City *

Nominator State *

Nominator Postal Code *

Nominee Parent Information: Please share information about your nominee's parent or guardian

Nominee's Parent or Guardian Name *

Nominee's Parent or Guardian Email *

Nominee's Parent or Guardian's Number *

Best Way To Contact Nominee's Parent or Guardian *

Nominee's Parent or Guardian Address *

Nominee's Parent or Guardian City *

Nominee's Parent or Guardian State *

Nominee's Parent or Guardian Zip Code *

Tell Us Why: To maintain the integrity and most effective adult to teen ratio of the program there are limited spots available for the TWTS program. Let us know why your nominee should be one of them!

Tell us about your nominee and why you think she would be a great fit for the That's What Teens Say Program. *

What else should we know about your nominee, that may be relevant to their participation in the program? (confidential) *

Captcha

Important Information

Consideration for the Fall 2024 TWTS Program

Please have your nominee fill out the separate application form by Friday, October 25th, in order to be considered for the Fall 2024 TWTS program. Please send them to the application page.

APPLICATION FORM

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