Junior Achievement of West Texas, Inc.

Fill out the form below to be a JA volunteer.

Date:

Name:  First:  Last:

Company: Title:

Company Address:  MD/MS/MZ:

City:  State: Zip Code:

Work Phone: Ext.: Fax:

E-mail Address:

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Home Address:   Apt#:

City:  State: Zip Code:

Home Phone:     DOB: 

I prefer that all correspondence be sent to my: Home Address Office Address

Are you a returning JA volunteer? Yes No

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School Preference: ( Optional )

1st:   2nd: 

How did you hear about us?

Prior JA Volunteer? Yes No 
If yes, please specify year, program and school below

Did you know that only $25 will sponsor one child to receive a JA program?
Yes, I want to donate to support JA kids today: $ 
A JA representative will contact you regarding your donation.

CONDUCT STANDARDS 
(required)
Please read the Volunteer Conduct Standards below.  
All volunteers must agree and abide by these standards.  Please select the applicable button to 
complete your registration.


 
I AGREE  I DO NOT AGREE 
 

 

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