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-Led

Preferred Day of the Week

Preferred Month for Volunteer-led Deliveries

Delivery Time

AMPM

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-Led	Number of Students
Preferred Day of the Week	Preferred Month for Volunteer-led Deliveries
Notes 2 Delivery Time AMPM

Program No 3 (Optional)

Select Third Program to Enroll in How many Classes would you like to enroll for Program 3? Preferred Delivery Method (dependent on availability) Teacher-LedVolunteer-Led Program 3 Student Grade Level (If multiple grades, please pick the highest one) Preferred Month for Volunteer-led Deliveries Preferred Day of the Week	Number of Students Notes 3
Delivery Time AMPM

Contact Information