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JA Aspire Programme (10th - 12th Graders)Student Application Form
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Email
*
Your email
STUDENT INFORMATION
Name: (First, Middle, Last)
Your answer
Date of birth:
MM
/
DD
/
YYYY
NIB:
Your answer
Gender:
Male
Female
Clear selection
Current address:
Your answer
P.O. Box:
Your answer
Home Phone:
Your answer
Mobile Phone:
Your answer
Email:
Your answer
T-Shirt Size
XS
S
M
L
XL
2XL
3XL
4XL
5XL
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Island
Your answer
School’s Name:
Your answer
Grade:
Your answer
GPA:
Your answer
PARENT OR LEGAL GUARDIANS
Name: (First, Middle, Last)
Your answer
Relationship:
Your answer
Employment and/or Occupation:
Your answer
Work Phone:
Your answer
Mobile Phone:
Your answer
Email
Your answer
EMERGENCY CONTACT INFORMATION
Name: (First, Middle, Last)
Your answer
Relationship:
Your answer
Employment and/or Occupation:
Your answer
Work Phone:
Your answer
Mobile Phone:
Your answer
Email
Your answer
ASSIGNMENT INFORMATION
Are you a returning achiever?
Yes
No
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If you have answered yes, please complete the below questions:
Year:
Your answer
Programme:
Your answer
Company:
Your answer
Application Waiver:
By completing/signing and submitting this application you agree that the information is true and correct; and you also agree to work cooperatively, and abide by the Rules and Regulations of Junior Achievement Bahamas.
Student's Name:
Your answer
Submission Agreement:
*
By submitting this application I agree to the Application Waiver
Parent/Guardian's Name:
Your answer
Submission Agreement:
*
By submitting this application I agree to the Application Waiver
Please Select Desired Meeting Times By Location, Day, Time:
South: Anatol Rodgers Tuesday 5:30 - 7:30
West: St. John's College Tuesday 5:30- 7:30
ANATOL RODGERS STUDENTS ONLY: Tuesday 3:30 - 5:30
A copy of your responses will be emailed to the address you provided.
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