Junior Achievement of Southeastern Michigan

Volunteer Registration Form

Personal Information

Title: <-- Make Selection --> Dr.Mr. Ms.Mrs. Miss         Name: 

Email Address:          Date of Birth: 

Home Address:         Preferred Address: Home: Work

City/State:         Zip Code: 

Phone Number:         Ethnicity: 

Please list any affiliations you have with membership organizations or local initiatives (AARP, MACPA, IIA, Retired Teachers Association, HRAGD, SHRM, FPA, Right Management, Michigan Works, etc.) 

Business Information

Organization Name:        Job Title: 

Address:        Supervisor: 

City/State:         Zip Code: 

Mail Code:         Phone Number:  

Fax Number:         Email : 

I have read and understand JA's Volunteer Conduct Standards and Privacy Policies and will abide by them throughout the duration of my services as a Junior Achievement Volunteer.

Full Name:          Date:

Junior Achievement of Southeastern Michigan will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

Volunteer Opportunities:  Classroom (Traditional)Classroom (One Day) Rock Finacial JA Financial Park (One Day)Office Special EventsJob Shadow (hosted at your Office) FundraisingJA Ambassador (conducted presentations on JA behalf) no preference

Availability

Semester Preference: Fall (Sept-Dec): Spring (Jan-Jun): Summer (Jul-Aug): No Preference

Time Preference: Morning: Afternoon: Evenings: Full Day: Weekends: No Preference

Programs

Program Level Preference: High School: Junior High School: Elementary School: No Preference

Location/Teacher Preference: 

Junior Achievement Experience

Have you ever been a Junior Achievement Volunteer before?: Yes: No   Number of Years: 

Where?:   When?: 

Additional Support Opportunities (Please Make Check Payable to Junior Achievement.)

Junior Achievement is a 501 (c)3 charitable organization whose contributions are typically tax deductible. I know that $40 sponsors one student. Therefore, I would like to financially support JA this year with a gift of : $10: $40: $80: $125: $250: Other

I would like my gift designated for : 

Contribute online      

Or Mail Payments to: Junior Achievement of Southeastern Michigan, Inc. 577 Larned St., Ste 200, Detroit, MI 48226

Phone Number (313) 962-5689  Fax (313) 964-8884