"*" indicates required fields Are you registering a school or another student group?* School Other organization School Name* Organization Name* School Phone Number*Organization Phone Number*School Address* Street Address City State / Province / Region ZIP / Postal Code Organization Address* Street Address City State / Province / Region ZIP / Postal Code Will more than one class at the school participate in JA Inspire?* Yes, more than one class will participate this year No School Coordinator NameIf more than one class is participating, who will serve as JA's main coordinator? If just one class, please jump to Teacher section. First Last Coordinator Name* First Last Coordinator Phone*Coordinator Email* Principal Name* First Last Principal PhonePrincipal Email Teacher #1**For each teacher registering, please list their name, email, grade, and number of students participating.** Name Email Grade # of Students How many students will be participating in JA Inspire and in what grades? Grade # of Students Teacher #2 Name Email Grade # of Students Teacher #3 Name Email Grade # of Students Teacher #4 Name Email Grade # of Students Teacher #5 Name Email Grade # of Students Teacher #6 Name Email Grade # of Students Teacher #7 Name Email Grade # of Students Teacher #8 Street Address Address Line 2 City State / Province / Region Teacher #9 Street Address Address Line 2 City State / Province / Region Teacher #10 Street Address Address Line 2 City State / Province / Region Teacher #11 Street Address Address Line 2 City State / Province / Region Teacher #12 Name Email Grade # of Students I plan to have my students participate in the on-demand JA Inspire program (check all that apply):* I have my date set Fall Semester 2022 – Quarter 1 Fall Semester 2022 – Quarter 2 Spring Semester 2023 – Quarter 3 Spring Semester 2023 – Quarter 4 Who have you been working with at JA?*Jennie ClausenAden RamirezCindy BallantyneBrittany WilsonI haven't worked with anyone yetAdditional CommentsConsent*Junior Achievement Responsibilities: • Junior Achievement offers its curriculum to individual classrooms/organizations and will provide materials free of charge. • Junior Achievement will train teachers/facilitators as needed and will provide support throughout the JA program. Principal Responsibilities: • Principal/coordinator will allow JA staff to speak at a faculty meeting to train and review curriculum with teachers/facilitators. • Principals/coordinator agree that JA staff can communicate directly with teachers/facilitators to coordinate programs. • Principal/coordinator will agree to allow students to attend the JA Inspire Virtual Expo online interacting with the virtual vendors in accordance with JA USA COPPA Agreement (attached). • Principal/coordinator reviews and agrees with teacher/coordinator responsibilities listed below. Coordinator Responsibilities: • Coordinator agrees to help coordinate teacher/facilitator training. • Coordinator assists with scheduling JA Inspire preparatory programming and event attendance. • Coordinator assists with collection of pre- and post-student surveys from teachers/facilitators. • Coordinator works with JA staff to determine the number of students participating in JA Inspire Virtual event. Teacher/Facilitator Responsibilities: • Teachers/facilitators will work with JA staff to ensure that all sessions of JA Inspire are completed. • Teachers/facilitators will reserve class time for students to actively engage in the JA Inspire Virtual Career Fair. • Teachers/facilitators will help students explore the JA Inspire Virtual Career Fair and utilize student digital backpack and Student Digital Career Book, during and after their initial JA Inspire Virtual visit. • Teachers/facilitators will ensure that students complete the pre- and post-surveys and return them to JA Staff. By checking this box, I agree to the following items:Educator/Facilitator, Coordinator, or Principal Signature* Reset signature Signature locked. Reset to sign again
