Other Name (If you go by something other than your first name)
Gender (statistical purposes only)
Ethnicity (statistical purposes only)
Have you volunteered with JA before?
Please note that all new volunteers will be required to participate in a new volunteer training sessions prior to the first scheduled JA session. A JA staff member will contact you to schedule your training.
Company / School / Organization Name
Work Title (Job Title, Student, Parent or Retired)
Preferred Correspondence Method - Please Check All That Apply
Company / School / Organization Contact Information
Company Mailing Address
Company Street Address (if different from mailing address)
Company Phone Number and Extension
Company E-Mail Address
Home Contact Information
Home Mailing Address
Home Street Address (if different from mailing address)
Home Phone Number and/or Cell Phone Number
Home E-Mail Address
I would like to volunteer for the:
Please check preferred area(s) of interest:
Lower Elementary (K-2nd)
Upper Elementary (3rd-5th)
Middle School (6th-8th)
High School (9th-12th)
Please select which county (counties) that you would prefer:
Ohio Valley Region
Jackson Purchase Region
Have you been convicted of a felony within the last seven years?
If yes, please explain.
JA of West Kentucky
Volunteer Conduct Standards &
Social Media Policy
Please note, as part of obtaining the volunteer information sheet, all volunteers must annually review the JA of West Kentucky Volunteer Conduct Standards & Social Media Policy. This information may be reviewed using the following links:
Volunteer Conduct Standards
Social Media Policy
Please note that you do not need to print and return the above forms. By clicking submit below, you acknowledge that you agree to abide by the terms outlined in both the Volunteer Conduct Standards and the Social Media Policy.
If you would like for JA of West Kentucky to send a thank you letter to your immediate supervisor / manager or another individual within your company at the conclusion of the school year, please complete the following:
Supervisor / Manager Name
Mailing Address (Include Company Name, City, State and Zip)
Please Type Full Name
By submitting this volunteer information sheet for JA of West Kentucky,
you acknowledge that you have read and understand the parameters of both the
JA of West Kentucky Volunteer Conduct Standards and Social Media Policy!
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