2025-2026 Company Program Teacher Registration

JA Company Program Registration & Verification Form

Thank you for registering your students for the JA Company Program. Please complete all of the information below. A JA staff member will follow up with you in the Fall.
School Name*
Please enter complete school name, ex: Aventura Waterways K-8 Preparatory Academy
Teacher's Name*

First NameLast Name
Teacher's M-DCPS Email*
example@example.com
Teacher's Cell Phone Number*
Please enter a valid phone number.
Principal's Name*

First NameLast Name
Principal's M-DCPS Email*
example@example.com
School Phone Number*
Please enter a valid phone number.
Participating Class(es)

Please select the class(es) that will receive program (select all that apply).
Period 1
Period 2
Period 3
Period 4
Period 5
Period 6
Period 7
Period 8

Please fill out information for your participating classes.

I, First Name Last Name confirm that I completed/will complete the above JA program as a volunteer and/or educator.
Please attach your school's calendar and bell schedule.

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JA Company Program Registration & Verification Form