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20/21 JA Career Speaker Post-Program Survey (EI)
Tell Us about You
1.
What are the
first 3 letters
of your last name?
(Required.)
2.
When is your birthday?
(Required.)
Month
Date
Month/Date
-- Select an option --
January
February
March
April
May
June
July
August
September
October
November
December
-- Select an option --
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
3.
What is your teacher's last name?
(Required.)
4.
What grade are you in?
(Required.)
6th
7th
8th
Other (please specify)
5.
What school do you attend?
Current Progress,
0 of 6 answered
