JA Inspire Request Form

Thank you for your interest in participating in the JA Inspire Career Exploration Fair. Currently, participation is closed for the 2023-2024 school year. Please check back later to sign up to participate in 2024-2025.

If you have any questions or want to learn more, please contact Fiametta Elie, Work-Based Learning Program Manager at fiametta.elie@ja.org, or (401) 351-9860.

JA Inspire 2023-2024

Request Form

COORDINATOR/SCHOOL CONTACT INFORMATION

Coordinator Name

First Name

Last Name

Coordinator Email

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.

(###)

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School Name

School Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

School Phone

(###)

###

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Principal Name

First Name

Last Name

Principal Email

Do you plan to utilize the full curriculum or have a one day teacher-led session?

Full Curriculum

One Day Teacher-Led Session

Spanish Materials:

Will you need the JA Inspire curriculum translated in Spanish?

Yes

Are you able to provide computers and internet for all students?

Yes

N/A

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

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.