2024-25 JA Program Interest Form

2024-25 JA Program Interest Form

Complete this form to express interest in Junior Achievement's K-12 programming for the 2024-25 school year.
Name*

First NameLast Name
Email Address*
This email will be used to contact you in the future about JA Programs.
Phone Number*
Please enter a valid phone number. This number will be used to contact you in the future about JA Programs.
I am a:*

Classroom TeacherSchool based Administrator (Principal, Assistant Principal, Professional School Counselor)School District/Central Office based AdministratorHome School EducatorCommunity Partner/Youth-Serving OrganizationOther
Please select the home STATE of your school/institution/organization.*
Please select the name of the TENNESSEE SCHOOL DISTRICT/CHARTER SCHOOL NETWORK.*
Please select the name of the MISSISSIPPI SCHOOL DISTRICT/CHARTER SCHOOL NETWORK.*
Please select the name of the ARKANSAS SCHOOL DISTRICT/CHARTER SCHOOL NETWORK.*
Please enter the name of the associated SCHOOL DISTRICT/CHARTER SCHOOL NETWORK.*
Please enter the name of the SCHOOL/INSTITUTION/ORGANIZATION.*
Please enter the name of the DEPARTMENT.*
Please enter the FIRST & LAST NAME of your school's administrator. (Principal, Assistant Principal, or Professional School Counselor).*

First NameLast Name
Please enter the EMAIL ADDRESS of your school's administrator (Principal, Assistant Principal, or Professional School Counselor).*
example@example.com
Please enter the FIRST & LAST NAME of a member of your organization's leadership team (Manager, Director, or Chief).*

First NameLast Name
Please enter the EMAIL ADDRESS of a member of your organization's leadership team (Manager, Director, or Chief).*
example@example.com
For which grade level(s) are you requesting program(s)? Please check all that apply:*

Elementary: Kindergarten - 5th GradeMiddle: 6th Grade - 8th GradeHigh: 9th Grade -12th Grade
Please enter when you would like to start the program(s):*

FALL 2024SPRING 2025SUMMER 20252025-26 SCHOOL YEAR
Please use this space to include additional information, specific program or course name, or comments as needed:*

0/350
A JA representative will contact you shortly to follow up regarding your request!
Should be Empty:

2024-25 JA Program Interest Form

A JA representative will contact you shortly to follow up regarding your request!