PART 1: TEACHER INFORMATION
Teacher:
 

First Name

Last Name

School:
Grade/
Program:		   Number of students:
Gender:

Ethnicity:
Home Phone:
Work Phone:
Email:
Best times to reach you:
Is this your first year of JA at this grade level?
Do your classes . . .
     Meet at the same time everyday?
     Meet at the same time every OTHER day?

Please describe any schedule variations below.

 

 

PART 3: JA CLASS INFORMATION
Grade JA Program Length of Each Class Minimum # of Visits
6 JA Global Marketplace 45 minutes 6
7 JA Economics For Success 45 minutes 6
8 JA America Works 45 minutes 6
 
CLASS 1 Period #: Start Time: End Time: # in Class:
CLASS 2 Period #: Start Time: End Time: # in Class:
CLASS 3 Period #: Start Time: End Time: # in Class:
CLASS 4 Period #: Start Time: End Time: # in Class:
CLASS 5 Period #: Start Time: End Time: # in Class:
CLASS 6 Period #: Start Time: End Time: # in Class:

Days You Prefer For Your JA Program

ANY DAY Mon Tues Wed Thurs Fri

Frequency of Visits

My volunteer may come once weekly for 6 weeks.
My volunteer may come twice weekly for 3 weeks.
My volunteer may come daily for 6 consecutive days.
My volunteer may teach multiple sessions in one day.

Other Information



 

 

Contact Information
Lisa Brindle
Secondary Education Program Manager
Lisa.Brindle@ja.org
 

Junior Achievement of Northern Indiana

601 Noble Drive
Fort Wayne, IN 46825
www.JANI.org
Phone:  260-484-2543
Fax:     260-483-2133

 

 

PART2: VOLUNTEER PREFERENCES
The most successful and dependable volunteers generally come from teacher referrals. Please list potential role models that could serve as your JA volunteer(s) below.  You might consider parents of your students, past volunteers, business professionals, relatives, etc

PLEASE RANK ALL NOMINEES IN ORDER OF PREFERENCE
(1 = First choice for volunteer, 2 = Second choice, etc.)

Rank Volunteer Name Phone and / or Email
Phone:   Email:
Phone:   Email:
Phone:   Email:
Phone:   Email:
 
May we use a parent of a student as your volunteer?
Would your student teacher like to be your JA volunteer?
(If yes, please list name, college, and  phone / email below)
Name:   College:   Phone: Email:
Name:   College:   Phone: Email: