JA Inspire Request Form

Thank you for your interest in participating in the JA Inspire Career Exploration Fair. For the 2024-2025 school year, JA Inspire will take place December 10-12, 2024 at the Rhode Island Convention Center.

To request JA Inspire for your school, you can submit online via the form below or download a PDF of the JA Inspire Class Request Form.

Before signing up, please take some time to review the delivery requirements.

Completed forms can be emailed to Fiametta Elie, Work-Based Learning Program Manager at fiametta.elie@ja.org, or faxed to (401) 351-9860.

JA Inspire 2023-2024

Request Form

COORDINATOR/SCHOOL CONTACT INFORMATION

Coordinator Name

First Name

Last Name

School Name

School Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

School Phone

(###)

###

####

Coordinator Phone (cell)

Cell number required for on-site emergency contact at career exploration fair. If on-site contact will be different, please e-mail on-site contact name and number to kerry.schiff@ja.org.

(###)

###

####

Coordinator Email

Principal Name

First Name

Last Name

Principal Email

Do you plan to utilize the full curriculum or have the Abridged version of the Curriculum?

Full Curriculum

Abridged Curriculum

Will you need the JA Inspire curriculum in Spanish?

Yes

JA Inspire Career Exploration Fair Date Preference (First Choice)

JA Inspire Career Exploration Fair Date Preference (Second Choice)

TEACHER/CLASS REQUEST INFORMATION

Teacher Name 1

First Name

Last Name

Teacher Email 1

Teacher 1 - Classes Requested

Teacher 1 - Total # of students

Please enter the total number of students for all classes selected above.

Teacher Name 2

First Name

Last Name

Teacher Email 2

Teacher 2 - Total Classes Requested

Teacher 2 - Total # of students

Teacher Name 3

First Name

Last Name

Teacher Email 3

Teacher 3 - Total Classes Requested

Teacher 3 - Total # of Students

Teacher Name 4

First Name

Last Name

Teacher Email 4

Teacher 4 - Total Classes Requested

Teacher 4 - Total # of Students

Teacher Name 5

First Name

Last Name

Teacher 5 Email

Teacher 5 - Total Classes Requested

Teacher 5 - Total # of Students

Teacher Name 6

First Name

Last Name

Teacher Email 6

Teacher 6 - Total Classes Requested

Teacher 5 Total Classes Requested

Teacher 6 - Total # of Students

Teacher Name 7

First Name

Last Name

Teacher Email 7

Teacher 7 - Total Classes Requested

Teacher 7 - Total # of Students

Teacher Name 8

First Name

Last Name

Teacher Email 8

Teacher 8 - Total Classes Requested

Teacher 8 - Total # of Students

Teacher 9 Name

First Name

Last Name

Teacher 9 Email

Teacher 9 - Total Classes Requested

Teacher 9 - Total # of Students

Teacher 10 Name

First Name

Last Name

Teacher 10 Email

Teacher 10 - Total Classes Requested

Teacher 10 - Total # of Students

Acknowledgement

Coordinator has read and agreed to Delivery Requirements.

The principal is aware of Delivery Responsibilities and has approved these requirements.

By clicking the 'Submit' button below, you acknowledge that you have agreed to the school responsibilities or delivery requirements for offering JA Inspire. The responsibilities will be emailed to you following the submission of this form or can be reviewed on the delivery requirements page under the educators tab in the navigation.