JA Inspire™ Interest Form
Please complete by Wednesday, March 23, 2022
To learn more, see the JA Inspire™ Program Brief below:
Name of your school district:
Name of your school(s):
Would students from your school participate in JA Inspire™?
Yes
No
Need More Information
If so, what grade level(s)?
8
9
10
11
12
Total number of students participating:
Rank your preference for timing of the event:
Other date suggestions:
We welcome your input! Please share suggestions to help us better serve your students. If you are unable to attend, please help us understand why in this section. Thank you!
Please provide the name(s) and contact information for school staff that we should work with as we continue with JA Inspire™ planning.
Name
Phone Number
Email
Name
Phone Number
Email
Name
Phone Number
Email
Name
Phone Number
Email
Submit
Should be Empty: