*1.First and Last Name(Required.)

*2.Email Address(Required.)

*3.School(Required.)

*4.Grade(s) you teach(Required.)

*5.How many students will you have?(Required.)

*6.Would you like to complete teacher-taught curriculum or work with a community volunteer?(Required.)

Teacher-taught

Work with a community volunteer

*7.Preferred Semester for Junior Achievement(Required.)

Fall

Spring

Either

Both (Middle and High School only)

*8.If In Middle School or High School, what program are you requesting? For more information on our programs, visit jaforkids.com. If you would like to request information be sent to you, please indicate that in your answer. If elementary, type N/A.(Required.)

*9.Elementary teachers, please indicate if you prefer the traditional multiple classroom visits OR “JA in a Day” (volunteer teaches all 5 lessons in one school day). Please note: All “JA in a Day” programs must be completed by the entire grade level in your school on the same day. (Required.)

Traditional multiple classroom visits

JA in a Day

I am in a middle school or high school classroom.

*10.If requesting JA in a Day, please indicate 2-4 potential dates for programming below? If middle school or high school, type N/A.(Required.)

*11.If requesting traditional multiple classroom visits, what days of the week/times of day will work best? Please note: you and your classroom volunteer will coordinate exact dates/times together.(Required.)

12.Do you have a volunteer request or suggestion? If so, please also leave their contact information.