Virtual Company Student Registration and Permission Form
In order to ensure that JA Ottawa is providing a safe environment for all participants in the JA Company Program, we require all participants to read and fill out the following form. Students are now joining a program with millions of teens from around the world who have started and operated real businesses. Your Company team will use creativity, planning, marketing, sales, organization, and leadership to start an actual business. Whether you aspire to be an entrepreneur or not, you will gain essential workplace skills such as: problem solving, communication, innovative thinking and teamwork.
Participant Name
*
First Name
Last Name
Participant Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School name
*
Grade
*
Grade 9
Grade 10
Grade 11
Grade 12
School Board
*
OCDSB
OCSB
CECCE
CEPEO
Previous JA Company Experience?
*
Yes
No
If so, please let us know what year and school
*
What skills do you hope to develop?
Please separate by commas.
What are some of your strengths?
Please separate by commas.
JA Company has several elected roles offering different teams to be part of. Please select the preferred team you’d like to be on:
*
HR
Production
IT
Sales
Marketing
Finance
Are there any other students who you want to be in your Company?
How did you hear about JA?
Availability (When would you be available for your JA Company meetings?) The more flexibility the better.
Tuesday 3:00/3:30 pm (start)
Tuesday 4:30/5:00 pm (start)
Wednesday 3:00/3:30 pm (start)
Wednesday 4:30/5:00 pm (start)
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Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
Emergency Contact relationship to you
*
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
-
Area Code
Phone Number
Parent/Guardian Email
*
example@example.com
I PERMIT JA to use the participant’s information for the following purposes:
Name in print or electronic media for JA informational and/or promotional materials (video clip, annual report, brochure, website, newspaper, social media, etc)
Image in print or electronic media for JA and/or promotional materials (video clip, annual report, brochure, website, newspaper, social media, etc)
Achiever Directory (for Advisors or other achievers to contact you within program context)
JA mailing lists (to receive info on special events, awards)
All of the above
Date
-
Month
-
Day
Year
Date
Student Signature
*
Clear
Parent Signature
*
Clear
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Submit
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