JTEEN Membership Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If you are a Jewish teen education or engagement professional, Jewish Teen Education & Engagement Network is for you. We are excited to grow and strengthen our network in order to enhance the Jewish teen field.

Email *

Name *

Organization *

Title? *

Full Address (street, city, state, zip) *

Phone Number *

Website Address *

# of years in Jewish teen field? *

Degrees or certificates completed? *

Area(s) of expertise where you can support colleagues? *

Are you interested in a leadership position with JTEEN? If yes, in what capacity are you interested in serving? *

Are you interested in a Professional Membership (direct service), Partner Membership, or Independent Contractor/Educator Membership? *

Professional Membership

Partner Membership

Independent Contractor/Educator Membership

Required

If seeking the Professional Membership, select the number of teens you serve. *

First Time Member ($90/annually for 1 professional + $36 each additional professional)

Renewal ($180/annually for 1 professional + $36 each additional professional)

Not seeking a Professional Membership

Required

If seeking a Professional Membership, how many professionals are you registering? *

1 professional - included in membership fee

2 professionals - $36 extra ($216 total)

3-4 professionals - $72 extra ($252 total)

5+ professionals - $108 extra ($288 total)

Not seeking a Professional Membership

Required

If seeking an Independent Contractor/Educator Membership, select this category. *

$118/year

Not seeking an Independent Contractor/Educator Membership

Required

If seeking a Professional Membership or Independent Contractor/Educator Membership, what is the approximate number of teens you serve? *

If seeking the Partner Membership, select correct budgetary category. *

< $1 million ($360/year for up to 3 staff members)

> $1 million ($540/year for up to 3 staff members)

Premier Partner Membership ($1,800 annually for additional membership benefits and unlimited staff members)

Not seeking a Partner Membership

Required

If seeking a Partner Member, what is your annual budget?

How do you plan to pay for your membership? *

Check

Credit card

Venmo, Zelle, or PayPal

Comments

We are thrilled to have you in the Jewish Teen Education & Engagement Network! Contact Erica Hruby if you have any questions at ericanhruby@jteenprofessionals.org.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of JTEEN. Report Abuse

Forms