First Name*
Last Name*
Email*
Region*
Arnprior
Belleville
Brighton
Carlton Place
Cobourg
Cornwall
Georgian Trails
Grey Bruce
Haliburton
Kingston
Lakeshore West
Lindsay
Muskoka
Napanee
Pembroke
Peterborough
Port Hope
Prescott-Russell
Quinte West
Renfrew
Stormont Dundas & Glengarry
Trenton
Arnprior
Belleville
Brighton
Carlton Place
Cobourg
Cornwall
Georgian Trails
Grey Bruce
Haliburton
Kingston
Lakeshore West
Lindsay
Muskoka
Napanee
Pembroke
Peterborough
Port Hope
Prescott-Russell
Quinte West
Renfrew
Stormont Dundas & Glengarry
Trenton
Program of Interest
Be Entrepreneurial (BE)
Business Basics
Company Program (in school)
Dollars with Sense GR7
Economics for Success GR8
Not Sure
Our Business World GR5
Trade and Technology
Our Community
Be Entrepreneurial (BE)
Business Basics
Company Program (in school)
Dollars with Sense GR7
Economics for Success GR8
Not Sure
Our Business World GR5
Trade and Technology
Our Community
Language Spoken
English
French
Other
English
French
Other
Preferred Delivery Language
--None--
English
français
Business Phone
Home Phone
Volunteer Availability
Morning
Afternoon
Full School Day
Morning
Afternoon
Full School Day
JA Alumni?
Volunteer Notes