Junior Achievement Elementary School Program Request

1. Click here for Program Descriptions for each grade
2. If your schedule changes after you complete this form, please contact us immediately
3. JA Programs should be offered to the students once during the school year and there should be only one JA Program per grade level. 
   
   

* 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* <-- Make Selection -->African AmericanAlaskan NativeAmerican IndianAsianCaucasianHispanicHawaiianMulti-Racial

Elementary School Programs

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.)  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

Other Schedule or comments about scheduling the classes  

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.