Virtual JA Ambassador Fall 2021 Cohort
In Partnership with East County YMCA
Participant Name
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First Name
Last Name
Participant Age
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Participant Email
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example@example.com - do not use your student email, this must be a personal email
Parent/Guardian Email
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example@example.com
Participant Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Participant Phone Number
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Participant School / Organization
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Participant GPA
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This is for informational purposes and will not be used when considering acceptance to program.
Particpant Gender
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Particpant Ethnicity
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How did you hear about this program?:
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What do you plan to do after high school?
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Trade/Vocational School
Community College
California State University
UC or Private 4-year University
Career Track
Undecided
Please consider me for a program scholarship
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Yes
No
Participant Narrative
Please answer the following application questions:
Please share with us your general background information, including but not limited to, interests, values, family, and educational goals.
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Describe the most significant challenge you have faced and the steps you have taken to overcome this challenge.
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What do you hope to achieve through participation in this program? How will this program impact you, your family, and your community?
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Junior Achievement’s mission is to connect young people to industry by pairing students with mentors. What industries or career pathways are you most interested in?
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I agree to participate and engage in all 10 Zoom JA Ambassador's Sessions.
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I Agree
Participant Signature / If under the age of 18, please have a parent/guardian signature
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Program Payment
Skip this step if you would like to be considered for a full or partial scholarship. Please copy and paste the link and select 'Fall Ambassador Program East County YMCA' to complete payment for program: https://secure.qgiv.com/for/jambpro/
Submit
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