Please fill out the form below to be a JA volunteer. 

Month: <-- Make Selection -->MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day: <-- Make Selection -->12345678910111213141516171819202122232425262728293031 Year: Year: <-- Make Selection -->20062007200820092010

Name: <-- Make Selection -->Mr.Ms.Mrs.Dr.  First:   Last: 

Company:    Title: 

Company Address:  

City:   State: Zip Code: 

Work Telephone: Ext.: Fax Number:   Cell Number:

Email Address: 

Supervisor's Name: 

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Home Address: Apt.#: 

City:   State:   Zip Code: 

Home Phone:   Date of Birth: 

I prefer that all correspondence be sent to my:   Home Address: Work Address

Race/Ethnic Origin:
                 African AmericanAlaskan NativeAmerican IndianAsianCaucasianHawaiianHispanicMulti-Racial

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Program Level Performance: (Hold "Ctrl" key to make multiple selections)

School Preference:

1st:   2nd: 

 Elementary SchoolOurselves (K)Our Families (1st)Our Community (2nd)Our City (3rd)Our Region (4th)Our Nation (5th)Our World (6th)   Middle SchoolJA Personal EconomicsJA Enterprise in ActionInternational MarketplaceJA Global MarketplaceJA Economics for SuccessJA America Works   High SchoolJA Success SkillsJA EconomicsJA Econ w/TitanJA Titan

Class Time Preference: 8-11 am: 11-1: 1-3 pm  Semester: Fall: Spring: Both

How did you hear about us?   WorkplaceInternetSchool 

Prior Volunteer: Yes: No
If yes, please specify year, program and school below.

Are you a JA Alumni? Yes: No
If yes, please specify year, city and state of participate below.

CONDUCT STANDARDS
(required)

Please print and read the Volunteer Conduct Standards for our records.
All volunteers must agree and abide by these standards.  Please select the applicable button to
complete your registration.