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Volunteer & Teacher Completion Statement Form
"
*
" indicates required fields
I am a(n):
Educator
Volunteer
Basic Information
Name
*
First
Last
School Information
School name where JA was taught
*
Classroom teacher name
*
Grade Taught
*
Please select one
K-5th
6th-8th
9th-12th
Other
JA Program Taught
*
Kindergarten - JA Ourselves®
1st Grade - JA Our Families®
2nd Grade - JA Our Community®
3rd Grade - JA Our City®
4th Grade - JA Our Region®
5th Grade - JA Our Nation™
JA Career Speaker Series
JA More Than Money
JA Money in Motion Lite
JA My Journey
Other
JA Program Taught
*
JA Economics for Success®
JA It’s My Future™
JA Career Speaker Series
JA STEM Summit
JA It's My Job
JA More Than Money
JA Money in Motion Lite
Other
JA Program Taught
*
JA Career Speaker Series
JA Personal Finance
JA STEM Summit
JA Be Entrepreneurial®
JA Career Success™
JA Economics®
JA Student Stock Market Challenge
JA It's My Job
JA All About Cars
Other
How many JA lessons were completed?
*
Please select one
3
4
5
6
Other
I certify that I completed the above program in accordance with JA USA Implementation standards.
*
Yes
No
Educator Feedback
I would recommend JA programs to another educator
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
My JA volunteer was adequately prepared
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
JA staff was supportive
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
My JA volunteer successfully established a rapport with my students
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
The activities of the JA program were effective in engaging the students
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
Volunteer Feedback
I would recommend volunteering with JA to a friend or co-worker
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
My JA staff contact was helpful and supportive (if needed) throughout my experience
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
I would be interested in volunteering again
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
I had the training and tools to prepare for teaching my JA program
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
Volunteering for Junior Achievement has strengthened my professional skillset (ex: communication, time management, public speaking, etc.).
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
The classroom teacher provided me with enough support
*
4 - Strongly Agree
3 - Agree
2 - Disagree
1 - Strongly Disagree
N/A
Please explain why you provided that rating
The teacher remained in the classroom while the students were present.
*
Yes
No
Optional: Additional Feedback
Please provide any feedback or recommendations for the future:
Please share a short story that illustrates the impact of JA programs on the students so that we can share it with others – a funny moment, an anecdote, or a light-bulb moment:
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