Student Application JA Rising Women BTS - Wednesdays Feb 17 - May 18. Personal Statement of Interest - please attach PLEASE PRINT LEGIBLY

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2015-2016 JA Rising Women BTS - Wednesdays Feb 17 - May 18 Student Application PLEASE PRINT LEGIBLY Student Name: High School: Grade: Home Phone: Cell Phone: Address: E-mail Address: Did you previously participate in a JA program? Emergency Contact Name: Relationship to Student: Home Phone: Cell Phone: Work Phone: Address: E-mail Address: Personal Statement of Interest - please attach Your experience in the JA Rising Women Program program will help you pursue future goals and provide you with tools to succeed in your academics and career endeavors. The benefits of this program correlate directly to your commitment and effort. JA Rising Women students must be responsible, professional, and able to think creatively in a real world context. In 250-500 words, explain why you think you will be an asset to this program and why you are interested in this opportunity. For example, you can describe your strengths, interests, ideas, past experiences, future goals, or personal expectations. (Please use a separate sheet of paper. Your personal statement should be typed, double-spaced, and include your name and the date.) 1

Student Conduct Standards Due to the extra-curricular nature of this program and the potential risks there are to young people, here are some basic rules for the JA Rising Women Program to ensure that your experience as a Student partici-pant is a positive and safe one. First, attendance will be monitored. If a Student is not present for a meeting and the Mentors were not notified prior to the meeting, the mentors will contact the Student s home to ensure safety and to confirm their attending in the following week. Mentors and JA staff have the right to dismiss a Student from the program if there is recurring Student absence and tardiness. Second, no Student can leave during a meeting without Mentor knowledge and approval. If the Student is leaving for another event, the Mentors must be notified at the beginning of the meeting. If it is for a Student Company sales event, or to purchase supplies, the decision as to which Students attend that activity is at the Mentors discretion. Third, Students are also asked to maintain appropriate conduct while at their Junior Achievement Company. You, the Student, directly impacts the reputation of your company. Therefore, appropriate conduct and a respectful atmosphere are required at all times. Examples of inappropriate conduct include: Violation of state laws regarding alcohol, smoking, or any other illegal substances Dress (t-shirts or apparel) that contains profanity or inappropriate language Use of profanity or inappropriate language during the JA Rising Women Program These standards are designed to help provide a positive experience for all JA Rising Women Students and Mentors. Violation of these rules could result in suspension and in extreme cases removal from the program. These are examples only and are not intended to be a comprehensive list. There could be other actions not listed herein that could result in suspension or dismissal. The JA Staff and host site Mentors reserve the right to dismiss a Student for violation of these standards of conduct. The main purpose of the after-school program is to learn and have fun. It is also important to have a respectful atmosphere and safe environment for all students and Mentors. I have received a copy of the Student Conduct Standards and have read, understand, and will abide by them. By submitting this application, I confirm that I: Understand attendance at meetings is mandatory, barring unforeseen circumstances, and any planned absences must be reported to a JA staff or volunteer in advance Have reliable transportation to get to and from meetings and events. I can be on time to the Host Site location based on my proximity. Have a professional email address that I will use for the JA Rising Women Program **If these requirements are not met, you may be dismissed from the program** Student Name: (Please Print) Student Signature: Parent/Guardian Signature: Date: 2

Parent/Guardian Consent Form Your son/daughter would like to participate in the JA Rising Women Program. This program allows them to work with students from other schools and corporate volunteers to cre-ate and run their own business. Your child is required to attend weekly meetings for this program, on a date and at a time dependent on their specific Host Site. He or she must participate for the entire length of the program, which is typically 13 weeks. Corporate volunteers from the Host Site Company will work with your child to offer them advice and support as the program continues. All volunteers have cleared a background check in order to participate at mentors of youth. For your child to participate, you must complete this form and your child must return it with the other application materials. Thank you. Permission to participate in JA Rising Women: My child may participate in the JA Rising Women Program for the 2015-2016 academic school year. Medical Authorization Should it be necessary for my child to receive medical attention while participating in JA Rising Women, Junior Achievement will use provided contact information to determine details for where the family would like medical attention to be given. By signing this, I hereby agree to the above authorization: Date 3

Photo/Video Release Form By participating in the Junior Achievement program, students may be videotaped or photographed. These tapes and photographs may be used by local media and in future publicity and promotional efforts for Junior Achievement or our affiliated partners. In consideration of the opportunity to be pictured as described below, I,, hereby grant the right to photograph and/or video tape (hereafter called "media") me. I grant Junior Achievement of Central Maryland and its affiliated corporate partner(s) the ir-revocable right and permission to: 1) Reproduce, use, re-use, publish, display, copyright and distribute all media taken in which I might appear and in connection with any and all media now known or hereinafter developed. 2) Reproduce, use, re-use, publish, display, copyright, and distribute the same, individually or in conjunction with other photographs, images, text, and/or captions in connection with any promotion, advertising, and publicity of Junior Achievement of Central Maryland and/or the affiliated corporate partner(s) in all media. I also grant Junior Achievement of Central Maryland and the affiliated corporate partner(s) the irrevocable right and permission to reproduce, use, re-use, publish, display, and distribute those media in which I appear for all other purposes, including commercial, in perpetuity. I also release and discharge Junior Achievement of Central Maryland and the affiliated corporate partner(s), knowing that Junior Achievement of Central Maryland and the partner(s) are relying on this release at substantial cost, from any and all claims, demands and liability in connection with the use of such media in connection with Junior Achievement of Central Maryland and the affiliated partner(s), including but not limited to claims for libel, invasion of privacy, rights of publicity and/or copyright infringement. I understand that the copyright to all media resides with Junior Achievement of Central Maryland and the affiliated corporate partner(s). Signed: Print name: Parent or guardian signature (if minor): Date: 4

Recommendation Form To be completed by high school teacher or academic advisor JA Rising Women, an after-school Junior Achievement program run by community volunteers, allows students to create and run their own business. The personal and professional experiences they gain through this program, both on their own and from volunteer mentorship, will help them pursue their future career and entrepreneurial goals. This is an intensive program, and requires a certain level of competency and commitment. Based on your experience as a high school teacher or academic advisor for, please fill out the following short survey as you believe they relate to this Student: He/She is responsible and will take this commitment seriously. He/She is a good student and completes assignments fully and in a timely manner. He/She is reliable. He/She is creative. He/She works well with other students. He/She is a leader. He/She would benefit from the JA Company Program. Please describe why this student is a strong candidate for the JA Rising Women Program. Your completion of this survey is used to determine the student s ability to participate in and benefit from the program and is not considered a program placement guarantee to the student. THIS FORM IS REQUIRED AS PART OF THE COMPLETE JA RISING WOMEN APPLICATION. Your Name and Title: (Please Print) Your Signature: Date: 5

Frequently Asked Questions What is JA Rising Women? JA Rising Women is a free after-school program for female students, grades 9-12, who attend Howard County high schools. The program is held at community sites in Howard County. In JA Rising Women, students are organized into companies, and undergo every step in the process of creating and running a business. With the help of corporate mentors, the students actually create a product or service, raise capital, advertise and sell their product, and liquidate at the end of the program. Students are elected into leadership roles and organized into appropriate departments/functions. This is an excellent way for high school students to get real-world experience running a busi-ness, while being mentored by seasoned professionals. Who runs the JA Rising Women Program? JA Rising Women is run by Junior Achievement of Central Maryland. Community volunteers at the Host Site coach students throughout the program process as needed. A team of multiple volunteers works directly with the Host Site s student company. How long does the JA Rising Women Program run? JA Rising Women runs for 13 weeks, with the students meeting once a week for 90 minutes at the Maryland Center for Entrepreneurship at 9250 Bendix Rd., Columbia, MD 21045. Meetings will be held Wednesdays from 5:00 to 6:30 p.m. beginning February 17 and ending May 18. There will be no meeting on March 30 during spring break. Inclement weather policy: If schools are closed due to weather, the meeting will be cancelled and rescheduled. If schools are delayed in the morning, the program will run as scheduled in the evening. If schools are dismissed early, the meeting will be cancelled and rescheduled. What is a professional email address? A professional email address is an email address you would feel comfortable giving to a potential employer. Examples would include: JohnSmith@gmail.com, JSmith@gmail.com. 6