Fill out the form below to be a JA volunteer.
Date: MonthJan.Feb.Mar.Apr.MayJun.Jul.Aug.Sept.Oct.Nov.Dec. Day01020304050607080910111213141516171819202122232425262728293031 Year2001200220032004200520062007200820092010
Name: Select OneMr.Mrs.Ms. 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#:
Home Phone: DOB:
I prefer that all correspondence be sent to my: Home Address Office Address
Are you a returning JA volunteer? Yes No
Race/Ethnic Origin: Asian or Pacific IslanderAmerican Indian or Alaskian NativeBlack, not of Hispanic originHispanicWhite, not of Hispanic originOther
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~School Preference: ( Optional )1st: 2nd:
Class Time Preferences: 8-11 am 11-1 1-3 pm Semester: Fall Spring Both
How did you hear about us?WorkplaceSchoolInternetFriend/Co-workerJA siteNewspaper/MediaOtherPrior JA Volunteer? Yes No If yes, please specify year, program and school below
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. VOLUNTEER CONDUCT STANDARDS Each year Junior Achievement staff shall convey these standards in writing to all volunteers prior to their first visit to the classroom. Staff shall review these standards verbally, as well, with volunteers teaching for the first time. Junior Achievement serves youth. Our volunteers teach valuable lessons with each word and especially with their conduct. Adult misconduct with youth carries serious consequences. Because Junior Achievement cares that its volunteers have healthy relationships with the youth they serve, it has established these standards. 1. Young people look to adults for examples of appropriate behavior. JA volunteers must use appropriate language and model honorable behavior, such as respect, integrity, honesty, and excellence. Profanity or sexualized language or jokes is inappropriate around students. Violating state law regarding interactions with youth, e.g., providing them alcohol or illegal drugs, is forbidden. 2. Volunteers must take particular care when touching youth. Most people understand the difference between appropriate touching, like a handshake or pat on the back, and touching which is sexual or disrespectful. Volunteers must also consider how any physical contact may be perceived. 3. Interactions with students must both be appropriate and appear appropriate. Volunteers will spend most time with groups of students, although occasionally one-to-one situations may occur. Prior to any one-to-one interaction, a JA volunteer generally should ensure another adult is present or aware of the situation. Favoritism, or the appearance of favoritism, should be avoided. 4. Volunteers are responsible for the quality of interactions. Students often find it difficult to state discomfort or objections. Volunteers must be especially sensitive to physical and verbal cues that youth provide. These are examples only, not a comprehensive list. Other actions not listed could result in suspension or dismissal as a volunteer. Junior Achievement takes all complaints of misconduct seriously. Credible allegations of misconduct will be promptly investigated by the appropriate authorities. During any such investigation, the JA volunteer will be placed on leave. If an investigation determines misconduct occurred, it will result in the immediate and permanent dismissal as a JA volunteer. Any JA staff member or volunteer who reasonably suspects misconduct must report these suspicions immediately to the appropriate JA staff person at the local office. I have received a copy of Junior Achievement's Volunteer Conduct Standards and have read, understand, and will abide by these standards. Please return this form to the Junior Achievement office. By clicking on the "agree" button, I hereby certify that I have never been charged with a crime of violence or a crime involving a child or young person, or, if I have, that I have fully disclosed in writing the facts regarding such a charge to the local Junior Achievement office.