Zoho Creator- JA BizTown Date Signup

JA BizTown Date Signup

School Information

School *

County *

Address *

City *

State *

Zip *

Principal *

School Hours (Student Hours) *

Number of Classes Attending *

Total Number of Students (projected) *

Contact Information

Primary Contact Name *

School Phone *

Ext

Email *

Home Phone

Please list the names of the teachers that you anticipate will be teaching the JA BizTown program & the orientation they select. All teachers new to the JA BizTown program are required to attend one of the New Teacher Orientation dates. All returning JA BizTown teachers may receive the 2009-2010 program updates via Online Return Teacher Orientation, but are welcome to attend a Return Teacher Orientation on site. Materials may be picked up at any time after our first scheduled orientation session, or shipped to the school with a charge of $15 per class or section.
If the name of the teacher is not known at this time, please indicate, "unknown".

Please note that a home/summer phone number is required for any August orientation request.

How many educators will be teaching the program *

1) Educator

1) Grade

1) New/Return

1) New Teacher Training

1) Return Teacher Training

1) Home Phone

1) Email

2) Educator

2) Grade

2) New/Return

2) New Teacher Training

2) Return Teacher Training

2) Home Phone

2) Email

3) Educator

3) Grade

3) New/Return

3) New Teacher Training

3) Return Teacher Training

3) Home Phone

3) Email

4) Educator

4) Grade

4) New/Return

4) New Teacher Training

4) Return Teacher Training

4) Home Phone

4) Email

5) Educator

5) Grade

5) New/Return

5) New Teacher Training

5) Return Teacher Training

5) Home Phone

5) Email

6) Educator

6) Grade

6) New/Return

6) New Teacher Training

6) Return Teacher Training

6) Home Phone

6) Email

7) Educator

7) Grade

7) New/Return

7) New Teacher Training

7) Return Teacher Training

7) Home Phone

7) Email

8) Educator

8) Grade

8) New/Return

8) New Teacher Training

8) Return Teacher Training

8) Home Phone

8) Email

9) Educator

9) Grade

9) New/Return

9) New Teacher Training

9) Return Teacher Training

9) Home Phone

9) Email

10) Educator

10) Grade

10) New/Return

10) New Teacher Training

10) Return Teacher Training

10) Home Phone

10) Email

School Dates

Please list four possible dates for your school to attend. Dates are scheduled on a first-come first-served basis. When planning please consider holidays, breaks, in-services, and conferences. If you need to schedule multiple days please list additional dates in the "Multiple Days" box.

1st Choice *

2nd Choice *

3rd Choice *

4th Choice *

Multiple Days

Share a Day

We prefer to share a day with (school)

The contact teacher for this school is

I Agree To

Participating educators/schools agree to:
    *Verify that the requested date(s) work with the school calendar.
    *Send all new teachers to a new teacher orientation and have returning teachers participate in a return teacher orientation (online option available)
    *Prepare students for the simulation using provided materials.
    *Recruit a minimum of 15, maximum of 28 adult volunteers & inform them of their training session. (numbers are split on a shared day)
    *Arrange Transportation to accommodate a 4.5 hour simulation. (unless approved by JA in advance)

Additional Comments/Questions

The information I have provided is true to the best of my knowledge. *

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