Jewish Teens Questioning Everything (J-T-Q-E)

Student Information

Name(Required)

First Last

Grade in school for 2025-2026 year(Required)

Email(Required)

Phone(Required)

Address

Street Address Address Line 2 City State ZIP Code

Parent Information

Parent 1 Name(Required)

First Last

Parent 1 Phone(Required)

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Parent 2 Name

First Last

Parent 2 Phone

Parent 2 Email

Parent Address(Required)

Street Address Address Line 2 City State ZIP Code

Emergency Contact / Additional Information

Emergency Contact(Required)

Any Medical Issues?(Required)

Media Release

We agree to all allow photographs on social media, newsletters, print media etc in a classroom environment

Yes

Agreement

All students must show proper classroom decorum with respect for all teachers and students. Please do not bring any food to any class. Bottled water is acceptable. Classes are tuition free after an enrollment fee of $18.00 per student to cover security costs.

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Parent Signature(Required)

Payment

Registration Fee

Price:

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