Western Impact Experience - JA Volunteer Registration

Thank you for your interest in participating as a JA Volunteer in Western University's Impact Experience! The information requested below will helps us validate your eligibility to volunteer.

Please note that all participants must be able to participate in training and preparation on campus on February 18th, 2025.

Before completing this form, please review our Volunteer Handbook to find out more about volunteering with JA South Western Ontario and the expectations of a JA volunteer.

Information on this form will NOT be saved if you close or navigate away from this page. Be sure to complete in full and submit.

If you need any assistance, please contact us at info@jaswo.org. We look forward to meeting you!

Hidden Prefill

Contact ID

Charter

Charter Account

Volunteer Status

Volunteer Registration Form Completed

TRUE

College/ University (hidden prefill with "Western University - Impact Experience")

Personal Information

Title

First Name

Last Name

Phone

Home Mailing Address

Home City

Home Province

Home Postal Code

Home Country

Preferred Email

Personal Email

Work Email

Volunteer Information

Do you work for any of these major JA sponsors

Why do you want to volunteer with JA?

List/Describe any past volunteer experience

What strengths and experience do you bring?

What challenges do you expect you might face?

What do you hope to convey to students?

Program Interests (Check all that apply)

When are you available to volunteer?

Do you have one or more partners you want to work with?

Partner(s) name(s)

If more than one partner, please separate each full name by a comma.

Reference Information

References may be required depending on the volunteer role to which you are applying. Please provide the name and contact information for someone who can speak to your suitability to become a JA Volunteer and to your experience with youth.

First Reference Name

First Reference Relationship to you

First Reference Phone Number

First Reference Email Address

Have you been convicted of a criminal offense?

Emergency Contact (optional)

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number

Media Consent

I authorize JA South Western Ontario (JASWO) and JA Canada to allow photographs and/or video footage of me to be used in communications related to JA’s programs and sponsors of these programs. I allow my name to be published in JASWO’s marketing materials which may include the JASWO website, JASWO print and web advertising, and JASWO social media channels.

I agreeI disagree

Volunteer Code of Conduct

By submitting this Volunteer Registration, I agree to have read, and do understand and agree to the volunteer screening protocol, code of conduct, and other details as outlined within the JASWO Volunteer Handbook.

I agreeI diasgree

By applying to be a Junior Achievement (JA) volunteer and submitting the Volunteer Application Form, I hereby declare that all information is accurate and complete.

- I agree to uphold the core values and mission of JA
- I authorize JA to contact the above references in connection with my volunteer application
- I understand that I may be required to provide further information in order to validate my volunteer status, including, but not limited to, providing a Police Records Check and/or a Vulnerable Sector Screening
- I release and hold harmless the above references and JA from any liability

Anything else you want to share with us?

Thank You

If you have questions, please contact us at info@jaswo.org