Form

Submit this form online to sign up or print it out and send by mail, MNPS School Mail (Route #6) or fax (615.297.8514).

To view details on each JA classroom program available before you begin, please click here.

Choose

I am flexible and can host a JA volunteer at any time throughout the school year.

I prefer to receive a JA volunteer during a particular month:

Indicate Month

First Name

Last Name

School Name

School Phone

School Fax

Home Address (for internal/summer communications only)

City

State

Zip Code

Home Phone (Confidential)

Cell Phone

Email

Please indicate your preferred method of communication:

Gender

MaleFemale

Ethnicity*

* This information is used for general statistical purposes only and, while not required, is appreciated.

Grade

Number of Students

Planning Period

Lunch

Other times during the day a volunteer CANNOT visit:

ELL/Special Needs

JA Programs Available:

Elementary (K-5): Please select program according to grade

Complete the following Program and Time indicators for Middle and High School class sections:

Please specify the following for each section in which you would like the JA program, noting semester changes and if you operate on A/B scheduling. (Example: JA Success Skills, 10-10:50 A Day, Fall; JA Success Skills, 10-10:50 B Day Fall)

*Please note: Volunteers are assigned based on availability and could mean not all classes will receive a JA volunteer. Please be prepared to coordinate schedules with different volunteers for each program request. If you have a very specific ask regarding volunteer assignments, please note below.

Program Desired

Class Period (Day/Time)

Program Desired

Class Period (Day/Time)

Program Desired

Class Period (Day/Time)

Program Desired

Class Period (Day/Time)

Program Desired

Class Period (Day/Time)

What subject(s) do you teach?

Attention Teachers: Request your JA Volunteer! If you would like to request a past volunteer, please indicate field below. Additionally, if you would like to recommend a new volunteer please provide their name and contact information so that we may get in touch with them.

Other Notes (Volunteer Request or Other Specific Class Information)

As a JA Teacher, I will:

Contact my volunteer as soon as I am notified to set up a schedule of visits, regardless of when the class will actually begin.
Have my students prepared and ready for the volunteer’s visit and create a positive learning environment.
Remain in the classroom at all times, maintaining discipline of my students and creating a respectful environment for the volunteer.
Let the JA staff know of any scheduling difficulties immediately. (Completion of the program is key to ensuring continued funding for JA!)

Form

Junior Achievement Teacher Agreement