Complete the on-line form below and click submit. 

Fields in red are required. 

One class/teacher per form, please.

 

SECTION 1-- Teacher Information

Have you had JA in your classroom before?  Yes No

Are you at a different school this year? Yes No

First Name:    Last Name:    

Salutation:    <-- Make Selection --> Dr. Mr. Ms. Mrs.    Gender:      <-- Make Selection --> Male Female

School:           District:    

Etnicity        Black/African American American Indian Asian White/Caucasian Hawaiian Hispanic Multi-Racial Information not provided  

Home Phone Number:   

Cell Phone Number: 

Work Phone Number:   Work Extention:          

Fax Number:            

School Mailing Address:  

Home Mailing Address: 

Email Address:   

Preferred Method of Contact:  <-- Make Selection --> Email Work Phone Home Phone Cell Phone Fax Mail

SECTION 2 -- Class Information:

School Year:  2009-2010

Expected # of Students:         Grade: K 1 2 3 4 5 6 7 8 9 10 1 12

Select a JA Program for a Volunteer to teach in your classroom::  <-- Make Selection --> Ourselves (K) Our Families (1st gr.) Our Community (2nd gr.) Our City (3rd gr.) JA More than Money (3rd - 5th gr.) Our Region (4th gr.) >JA BizTown curriculum and trip to JA World (4th - 7th gr.) JA BizKids(4th - 8th gr.) Our Nation (5th gr.) JA It's My Business (5th - 9th gr.) America Works (6th - 8th gr.) JA Economics for Success (6th - 8th gr.) JA Global Marketplace (6th - 8th) JA Job Shadow (6th - 12th gr.) JA Finance Park curriculum and trip to JA World (7th - 10th gr.) JA Be Entrepreneurial (8th - 12th gr.) NEW 2009! JA Business Ethics (8th - 12th gr.) JA Careers with a Purpose (8th - 12th gr.) JA Company Program (8th - 12th) JA Success Skills (8th - 12th gr.) JA Titan (8th - 12th ) NEFE High School Financial Planning Program (8th - 12th gr.) JA Banks in Action (9th - 12th gr.) JA Exploring Economics (9th - 12th gr.) <JA Economics – see Econ. Section below to order textbooks (9th - 12th)      

SECTION 3 --"JA Economics" High School Textbook

Please complete section 3 only if you are a High School Econ. teacher who will be using the textbook series JA Economics.  If this does not apply to you, skip to section 4.

JA Economics, 2007 edition
(full semester curriculum for grades 9th - 12th)

Number of JA Economics Student Textbooks (green):    

Number of JA Economics Student Study Guides (yellow): 

Number of JA Economics Teacher Guides (blue):          

Number of JA Economics Volunteer Guides (gold):       

Date Needed By:                           

Ship to: School : JA

School Shipping Address:             

Volunteer Involvement (required for free textbooks):  <-- Make Selection --> Volunteer teaching entire course (80 contact hours) JA Exploring Economics (new in 2008) JA Titan JA Banks in Action JA Success Skills JA Company Program Seven contact hours from teacher's curriculum

SECTION 4 -- Scheduling & Volunteer Info.

School Year: 2007-08: 2008-09: 2009-10

Semester:  <-- Make Selection --> Fall Spring Either

Room #:  

School Level: Elementary School Middle School High School Mixed Level (ie. Intermediate)

Delivery Method:
 JA in a Day for K-5th gr. (complete program in 3-4 hours on one day)
 1x/week for 5 weeks (45 min.per visit)
 Either

Is there a specific volunteer you'd like to request? If so, what is the volunteer's name?: 

Are you able to recruit a volunteer from your classroom parents,
student teacher, or school community?  

Are there any dates when you prefer to have a volunteer?
If so, when?: 

Does your classroom have any special characteristics (ie ESL, Special Needs, Gifted):