B-SAFE 2019 JCIT Application
Name *
First and Last
Your answer
Street Address *
Include Apt. Number
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City, State, Zip *
Your answer
Best Phone *
Your answer
E-Mail *
Your answer
School Attending *
Your answer
Current Grade *
Your answer
Are you between the ages of 13 and 15? *
Your answer
How did you hear about us? -If from friends or family, please name them.
Your answer
Why do you want to be part of the JCIT program? (List at least 3 reasons) *
Your answer
What do you want to teach younger kids? *
Your answer
What do you want to learn from being part of the JCIT program? What are some of your challenges, learning edges, weaknesses in working with younger kids? *
Your answer
Have you ever done community service? What was it? Was it fun? Would you be willing to do it again? *
Your answer
Are you available every weekday from July 2nd- August 8th from 9:00am-4:00pm?
Are you willing and able to commit to being part of a team, contributing to an open-minded and respectful environment, and engaging in all planned activities?
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