JA BizTown Trades Enrollment Form

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JA Trades Enrollment Form
School Name:
School District:
School Address
City, State, Zip (need all 3):
School Phone:
Coordinator Name:
Coordinator Email:
Coordinator Position
Coordinator Cell Phone #
Principal Name:
Principal Email:
Select Class Grade Level(s):
Preferred Month
Total Number of Students Enrolling
SIMULATION INFORMATION

NOTE: Simulations last approximately 3.5 hours based upon enrollment counts.
Simulation Type:
First Choice Simulation Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2nd Choice Simulation Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
3rd Choice Simulation Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Arrival Time
Departure Time
Are your students bringing lunch to their JA Trades visit day?
Additional Comments:
For additional comments or questions, please reach out to Joy Germeroth (jgermeroth@jastl.org) or Shelly Warner (swarner@jastl.org)
Should be Empty:

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