Teen Contact Information

Legal First Name*

Legal Last Name*

Birthdate*

Grade in School as of September 1, 2024*

High School Name*

Personal Email*

Cell Phone*

Street Address*

City*

State*

Zip Code*

Gender*

Religion*

Have you ever been to Israel before?*
YesNo

If yes, which trip?

It is okay to apply for this trip even if you have gone to Israel before. Please tell us why you want to go to Israel with Lappin Foundation's Youth to Israel Adventure.

Parent/ Guardian Information

Parent/Guardian 1
First Name*

Last Name*

Email*

Cell Phone*

Street Address*

City*

State*

Zip Code*

Relationship to Teen*

Parent/Guardian 2 - if applicable
First Name

Last Name

Email

Cell Phone

Street Address

City

State

Zip Code

Relationship to Teen

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