Junior Achievement Middle School Program Request

  1. Please list each class separately
  2. Click here for Program Descriptions for each grade
  3. If your schedule changes after you complete this form, contact us immediately
  4. JA Programs should be offered to the students once during the school year and there should be only one JA Program per grade level. If teaching a full-year course, please indicate which semester you would prefer the program. For a one-semester course, indicate the number of classes you project having each semester.

* Required fields

Teacher Name*    School*    District* 

Principal       School Phone*     

Email*      Classroom Phone  

Planning Time      Cell Phone     Home Phone  

You can reach me most easily by:  Email     School Phone     Cell Phone     Home Phone

Due to requirements for certain grants and funding, we need the following information:

Gender* Male Female            Ethnicity* 

Middle School Programs 

# of
Students

JA Program

Course Title

Period

Class Start Time

Class End Time

Fall or Spring

Full Year Class?

Comments

In an effort to better facilitate scheduling, please indicate below which month you would like your JA class to start.  (Elementary programs are 5 sessions; Middle School programs are 6 sessions; High School sessions are 7 to 8 sessions.)  We will make every effort to have your volunteer start in your requested month, but we cannot guarantee.  Please select all that apply:

September   October   November   January   February   March   April

Is this your first time to host a JA volunteer?    Yes      No

Do you have someone in mind to volunteer for your class?

If so, please put their contact information here. Volunteer Name    Volunteer Phone #  

Volunteer Email 
Is this person a former JA Volunteer?   Yes      No

NOTE:  Volunteers must complete the Volunteer Form.