Form

2012-2013 Volunteer Bio Form
Personal Information
Preferred County:*
Full Name:*
Prefix First Name Last Name

Home Address:*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Cell Phone:
- Area Code Phone Number
Home Phone:
- Area Code Phone Number
E-mail*
Months available to teach:

September-December January-June
Preferred School/Program:

Primary Business Information

If you are a high school or college student, enter School Information
Business Name:
Position:
if high school or college student, enter Student

Business Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Business Phone:
- Area Code Phone Number
Fax Number:
- Area Code Phone Number
Supervisor's Name:
If high school or college student, enter Teacher's Name.

Supervisor's Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Click Here to read our Volunteer Code of Conduct.

Click Here to read our Social Media Policy.
Required*

I have received copies of Junior Achievement's Volunteer Conduct Standards and Social Media Policy and have read, understand, and will abide by these standards.
Required*

I hereby certify that I have never been charged with violence, or any type of charge involving a child or young person, or, if I have, that I have fully disclosed in writing the facts regarding such a charge to my local JA Area.

Demographic information collected by JA is used for statistical purposes only. It is not used for individuals, but used only in aggregate form. JA is a non-profit organization that applies for grants and funding from various entities. In these applications, we need to provide statistical information to demonstrate that JA reflects the diversity of the communities we serve. We appreciate your assistance in ensuring JA’s continued service to our children.

Ethnic Background:
Gender:
Birth Date:
Month Day Year
I understand that this will serve as my electronic signature and that by clicking SUBMIT, I acknowledge that the information provided herein is accurate.
Should be Empty:

2012-2013 Volunteer Bio Form

Personal Information

Primary Business Information

JA Volunteer Experience