Program Confirmation Form (P.C.F.)

Welcome to JA World!

This form is confirmation that you have received our welcome email and that all the necessary, pertinent information is correct and updated in order to begin the journey to JA World. Please complete and submit this form within three (3) business days of receipt. If you have any further information please contact Debbie Fairholm at (954) 979-7107 or debbie@jasouthflorida.org.


A red asterisk (*) indicates required questions.

  1. Today's Date (MM/DD/YY):*


  1. School Name:  *


  1. Confirmed JA World Visit Day (MM/DD/YY):*


  1. JA World Lead Teacher's Name:*


  1. Lead Teacher's Email:*


  1. Expected Number of Students for JA World Visit Day:*


  1. Have you received a JA World Kit in the past five (5) years?*
    Yes
    No


  1. *If yes, please list what documents you need to be replaced.
    (Please type N/A if you answered "No" above)*


  1. *If no, please select from one of the below options with regards to getting a kit:*
    Pick up from JA World
    Receive at Teacher's Training 2016
    Drop off via Pony to the School
    Not Applicable





Junior Achievement of South Florida