Class Registration Form

2008-2009 School Year Class Registration Form

If you would like to register your classroom to receive a JA Program during the 2008-2009 school year, you may either complete the online form below, download the Word document at Class_Registration_Form_2008-2009.doc, download the PDF image at Class_Registration_Form_2008-2009.pdf, or contact our office to request a form.

This information should be submitted by the teacher, school JA site coordinator or other school personnel.  One form is required per classroom request. A list of the schools and/or counties we are scheduled to serve next school year are listed below.  If your school, county or grade level is not listed below, please contact the local JA office before submitting your class registration form.

Schools scheduled for JA programs next school year

Daviess County Schools:  Apollo High, Burns Elementary, Burns Middle (8th Grade), Country Heights, Daviess County High, Deer Park, Highland, Sorgho, Southern Oaks Elementary, West Louisville
Owensboro Public Schools:  Cravens, Estes, Foust, Owensboro 5-6 Center (5th Grade), Owensboro Middle, Owensboro High, Newton Parrish, Sutton
Owensboro Catholic Schools:  Owensboro Catholic K-3 Campus; Owensboro Catholic 4-6 Campus; Owensboro Catholic Middle; Owensboro Catholic High
Breckinridge County (entire county):  All Breckinridge County district schools, William Natcher Elementary and St. Romuald will have JA programs for all 4th and 5th grade students (Plans have not been finalized yet, keep checking our website for additional information)
Henderson County (entire county):  All Henderson County Schools will have JA programs for all 3rd and 6th grade students. (Plans have not been finalized yet, keep checking our website for additional information)
Muhlenberg County School District:  All 5th and 8th grade students at all district elementary and middle schools will receive JA programs. (Plans have not been finalized yet, keep checking our website for additional information)
Perry County -- Perry Central Community Schools and Tell City-Troy Township Schools will have JA programs for all 3rd and 8th grade students and a few high school classrooms.  (Plans have not been finalized yet, keep checking our website for additional information)
Afterschool -- Afterschool organizations should contact the local JA office regarding information on our offerings.

Class Registration Form
Please complete information below.  All information in red is required.

JA Program Information
Please select the JA program you would like to have for your classroom

Please select the program you wish to register for your class. 
(You can view the summaries and templates for each of our programs.  You can also view the correlations to see how each program meets the core content requirements for the Kentucky Academic Standards or the Indiana Academic Standards.  Each JA program may be taught one grade level below or above what is listed below.  Other requests should be directed to the JA office.)

Elementary Programs

 <-- Make Selection -->Kindergarten -- Ourselves1st Grade -- Our Families2nd Grade -- Our Community3rd Grade -- Our City4th Grade -- Our Region5th Grade -- Our NationJA More Than Money (formerly JA Dollars & $ense)

Middle School Programs

 <-- Make Selection -->JA Global Marketplace (Grades 6-7)JA Economics for Success (Grades 7-8)Afterschool -- It's My Business

High School Programs
(all programs can be used for grades 9-12)

 <-- Make Selection -->JA Banks In ActionJA Business EthicsJA Careers With a PurposeJA Economics (Semester Long Course)JA Success SkillsJA TitanJA Presents: The NEFE High School Financial Planning Program

Classroom Information
Please complete the following questions to provide complete and accurate information

Program Format
(Please check all that apply) 
Standard Format -- 1 to 2 times per week until all 5 (elementary), 6 (middle) or 8 (high) activites are completed.
JA in a Week -- (Elementary Only) -- Once a day for an entire week to complete all 5 lessons
JA in a Day -- (Elementary Only) -- Complete all 5 lessons in one day
Please Note:  For counties other than Daviess, the standard format may be the only option available.  For the JA in a Day, we will try to accomodate this format.  However, in the event we cannot find enough volunteers to cover our JA in a Day requests, we will work with you to schedule another format)

Special Requests -- Please answer the following:

Do you have a volunteer from last year you would like to have again? If so, please list his/her name.

Does your class need to take place at the same time as another class who has requested a JA program?
If so, please list the teacher(s) name(s).
 

Any other requests?
 

Classroom & Teacher Information -- Please answer all of the following questions.

Teacher's First Name: 

Teacher's Last Name: 

Teacher's Title: Mrs.: Ms.: Miss: Mr.: Dr.

School:                  

How many students are in your classroom?
Please note, you must have at least 10 students participating. If your classroom has less than this amount, you may want to join another
classroom. 

Which semester would you prefer?
 <-- Make Selection -->FallSpringEither

In which month(s) would you prefer to have your JA program(s)?
(Please check all that apply) 
September: October: November: December: 
January: February: March: April: May

School's Mailing Address
 

School's City, State, Zip
 

School's Phone Number

School's Fax Number 

Teacher's Email Address 

Alternate Phone (optional) 

Have you participated in JA before? Yes: No

If yes, how many years?1-2 years: 3-4 years: 5 or more years

What is the best method for JA staff and your JA volunteer to contact you?
(Check all that apply): 
School Phone
School Fax
Mail
Email
Alternate Phone