Hidden Prefill

Charter

Stage

Charter Account ID Input from Prefill

For more information about these programs and the various program delivery methods available please visit https://jacanada.org/saskatchewan/programs/
or email Larissa Steinley at lsteinley@jasask.org

Title

First Name

Last Name

School Name

School City

School Board

Be sure to select the program recommended for the class grade level and take care when completing this form. Accurate and complete information will enable us to make the appropriate arrangements for all JA programs.

Use the following menus to register up to three different programs:

Program No 1 (Mandatory)

Select First Program to Enroll in

How many Classes would you like to enroll for Program 1?

Program 1 Student Grade Level (If multiple grades, please pick the highest one)

Preferred Delivery Method (dependent on availability)

Teacher-LedVolunteer-LedVirtual Facilitation (pre-recorded)

Preferred Dates for Volunteer-led Deliveries (up to 3)

Notes 1

Number of Students

Program No 2 (Optional)

Select Second Program to Enroll in How many Classes would you like to enroll for Program 2? Program 2 Student Grade Level (If multiple grades, please pick the highest one) Preferred Delivery Method (dependent on availability) Teacher-LedVolunteer-LedVirtual Facilitation (pre-recorded)	Number of Students
Preferred Dates for Volunteer-led Deliveries (up to 3)	Notes 2

Program No 3 (Optional)

Select Third Program to Enroll in How many Classes would you like to enroll for Program 3? Program 3 Student Grade Level (If multiple grades, please pick the highest one)	Number of Students
Preferred Delivery Method (dependent on availability) Teacher-LedVolunteer-LedVirtual Facilitation (pre-recorded) Number of Students Notes 3

Contact Information