The JA Company Program Microsoft host-site will be held on Wednesday afternoons during the months of October through March. Engaging activities and successful adult role models will lead students through a program in order to start, manage and liquidate their own small business. Students will brainstorm product/service ideas, organize themselves into leadership teams, capitalize their venture and utilize marketing strategies to find and sell to their target market. Lastly, students will complete a final business report in order to potentially be invited to the National Student Leadership Summit. This is a 4-day experience for the top 15 student-led JA Companies from all over the United States to attend and compete for scholarships and other prizes.

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* 1. Please enter the name of the parent/guardian completing this application:

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* 2. Please enter the name of the student you are registering:

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* 3. Relationship to student:

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* 4. Please select student ethnicity:

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* 5. Please select the grade level of the student:

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* 6. What school does the student attend?

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* 7. What past Junior Achievement experiences has the student had? Please select all that apply.

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* 8. Please enter your email address:

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* 9. Please re-enter your email address:

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* 10. Please enter your home address:

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* 11. Please re-enter your home address:

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* 12. Please enter all phone numbers (and owner's name) we should have on file for when your student is in our care:

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* 13. Junior Achievement & Microsoft requires the right to photograph, video, and use testimonials from your student in media, social media, on our website, and in communicating with the public and our donors. Please indicate your approval for JA to feature your student's likeness and image and to tell your student's success story.

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* 14. I understand I am responsible for my student's transportation. Students attendance will be monitored, if a student is late or misses a meeting, parent/guardians will be notified by the host-site coordinator/s to ensure the student's safety. If a student misses multiple meetings or is often tardy, participation in the program may be revoked by the JA staff and/or Microsoft mentors.
Students will not be permitted to leave the host-site location during the meeting time for any reason unless it is pre-approved by the host-site coordinators. Students should see the coordinators prior to the start of the meeting to receive approval.

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* 15. I understand there is not a fee to participate in this program - however, students will need to capitalize their business and will be encouraged to buy a share of stock in the company at $5/share (max of 2 shares per student).

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* 16. Students will need to uphold appropriate conduct at all times. Students will be respectful to the host-site person/s, place and belongings; to JA staff; and to other students participating in the program. Further, students will need to dress appropriately while attending meetings or working with their company at various events. Proper attire, respectfulness and adhering to school/JA/host-site/state laws are required from all members participating.

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* 17. Students who participate in the JA Company Program® with Junior Achievement of Delaware are doing so with permission and consent of Junior Achievement USA®.
All materials and curricula belong to JA USA®. 
[2017, Junior Achievement USA®. All rights reserved. Used with permission by Junior Achievement USA®.]

522 S. Walnut Street  |  Wilmington, DE 19801  |  302.654.4510  |  www.jadelaware.org

Thank you for completing this application. Your confirmation will be emailed to you once all submissions have been reviewed.

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