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ALUMNI REGISTRATION FORM

Welcome to the registration page for Junior Achievement of New York Alumni Network. If you are a JA alumni currently residing in NYC or Long Island, or if you are a former JA New York student, please take a moment to fill out the form below.

Please make sure to fill out all required fields. All other fields are optional.
Required fields are marked by a (*).    
PROFESSIONAL INFORMATION
*Salutation:
*First Name:   *Last Name:  
*Company:   *Address:  
Floor/Suite:   *City:   *State:   *Zip:  
Work Phone:   Work Fax:   Work E-mail:  
 
PERSONAL INFORMATION
Home Address:   Apt:  
City:   State:   Zip:  
*Home/Cell Phone:   *Home E-mail:  
Where did you attend college?
What was your major?
Year of graduation
 
ABOUT ME:
In what grade(s) did you receive JA Programs?
Which JA programs did you participate in?

If Other please specify :
Would you be interested in attending JA Alumni networking or business events?
Are you interested in volunteer opportunities with JANY
Would you be interested in receiving JANY e-mail updates and electronic JANY newsletter
 
ALUMNI HISTORY:
Please list current membership in other social or professional groups, organizations and societies:
Please list other non-profit organizations where you serve as a board member or volunteer.
List special interests and pursuits:
List professional honors and awards: