2017-2018 Program Request Form

It is our hope that we can fill every class request, but completing this form does not guarantee we will be able to provide JA programs to your classroom. First, we must have funding for the programs. The cost for the JA programs is covered by donors, foundations, and corporations. We receive funding from many different supporters, but sometimes these donations are restricted to a certain county, school, curriculum, or even teacher. Secondly, we must have the volunteers willing and able to teach at the specific school.

Questions? Contact your Program Manager directly. Central: Elizabeth Blake (elizabeth.blake@ja.org), Bette Bronson (bette.bronson@ja.org). Coastal: Jeni Becker (jeni.becker@ja.org)

Name
Your answer
School
Your answer
email
Your answer
Phone Number
Your answer
Which grade/program are you requesting? Please note elementary programs are specific per grade. There is some flexibility in the middle and high school program.
Visit our website to learn more about each program: https://www.juniorachievement.org/web/ja-centralsc/programs
Select the program in the drop-down box below.
Who are you requesting the program for?
If you are requesting for the whole school or grade, please share the number of classes and the corresponding grades.
Your answer
Fall or Spring Preference
Your answer
Would you prefer a JA in a Day format? This is when all of the lessons are presented in a 3.5 hour period, usually 8:00- 11:30 AM.
Your answer
Additional Information
Your answer
Submit
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