*1.Student Name(Required.)

*2.Home Address(Required.)

*3.Phone Number(Required.)

*4.Personal Email address(Required.)

*5.High School(Required.)

*6.Grade level(Required.)

*7.Graduation Date(Required.)

*8.List all of the elementary schools where you have taught JA curriculum to students:(Required.)

*9.Tell us how being a JA High School Hero has impacted you:(Required.)

*10.Junior Achievement USA and Junior Achievement of Dallas (collectively “Junior Achievement”) engages with volunteers (“JA Volunteer”) to deliver K-12th grade programs in-person, online, or through other virtual means, for the purpose of fostering work-readiness, entrepreneurship and financial literacy skills. JA Volunteers deliver these programs featuring content provided by Junior Achievement (“JA Materials”), but JA Volunteers may also create and furnish content for use with these programs (“Volunteer Created Materials”). In presenting the JA Materials or the Volunteer Created Materials, the Likeness (defined below) of the JA Volunteer may be photographed, recorded or otherwise reproduced. This JA Publicity Release, Copyright Acknowledgement and Content License (the “Agreement”) authorizes Junior Achievement to use the Likeness of the JA Volunteer, clarifies the ownership of JA Materials and Volunteer Created Materials, and grants a license for Junior Achievement to use the Volunteer Created Materials and other content as described below.

To read the full media release, click here:

By my signature, I acknowledge that I have read, understand and agree to the terms above.

*Parent or guardian signature required if student is a minor.

Participant's Signature:(Required.)

*11.Parent/Guardian's Signature:(Required.)

12.Senior Photo (if under 18, refer to Q. 11 for parent/guardian consent)

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13.Participant's Date of Birth (DD/MM/YYYY):