Harnett County Early College
660 E. Johnson Street
Dunn, NC 28334
Wendy Roberson
Career Development Coordinator
Harnett County Early College
JOB SHADOWAPPLICATION
FALL 2018 JOB SHADOW DATE: October 19, 2018
You must have good attendance, good academics, and good behavior.
Please Print.
Student’s Name: ______HCS ID#: ______Grade: ______
Student’s COUGAR (CCCC) EMAIL:
Parent/Guardian’s Name: ______
Telephone numbers: (Cell) ______(W) ______
I have completed my Career Interest Self-Assessments in virtualjobshadow.org. The Career Cluster indicated for me is: ______
Job Shadowing 1st choice: ______
Job Shadowing 2nd choice: ______
If you have a SPECIFIC person in mind to shadow, please list the name and contact information: phone number, email, etc.). If you do NOT have a person in mind, I will assign someone.
Parent/Guardian’s Consent Section for Participation
in Job Shadowing & Photo/Video Consent
I hereby certify that my son/daughter, ______, has my permission to participate in the Job Shadowing program through Harnett County Early College. I understand that it is my student’s responsibility or my responsibility to provide transportation to and from the Job Shadowing site. To the best of my knowledge, my son/daughter is physically fit to engage in such activity and is not suffering from any disease or injury.
I agree and do hereby waive and release all claims against the Harnett County Schools and any teacher, employee, or other person engaged in the activity in question and agree to hold them harmless from any and all liability relating to my son/daughter for any personal injury or illness that may be suffered or any loss of property that may occur to my son/daughter.It is understood that no student will be allowed to participate in this activity until this form is signed by his/her parent or guardian.
I give permission to Harnett County Early College, the news media, or teachers/student teachers/ students to make, use and publish photographs, slides, videotapes, digital pictures or illustrations of my child in any medium. Further, I authorize their use without inspecting or approving the finished product or its specific use.
______
Signature of parent/guardianDate Best Telephone Number
Person to contact if parent(s) cannot be reached: ______
Contact’s telephone numbers: (Cell) ______(Other) ______
Return application to: Wendy Roberson, Career Development Coordinator.
COMPLETED APPLICATIONS FOR THE FALL
ARE DUE SEPTEMBER 19, 2018.
It is the policy of the Harnett County Schools that its facilities and programs are open to all students without regard to race, color, sex, religion, national origin, or handicap.
NOTE: The student is responsible for obtaining signatures/approval from teachers PRIORTOsubmitting this form to Mrs. Roberson.
HCECJOB SHADOWING PROGRAM
Teachers’ Approval for Student to Participate
TO SELECTED TEACHERS:
______is applying to participate in the HCEC Job Shadowing Program. In order to participate in the Job Shadowing Program, students must obtain approval from their current teachers. Students participating in the program must pass three “tests.”
- Good Attendance
- Academics (70 or higher)
- Good Behavior*
Teachers may also make recommendations based on other information he/she deems important.
BlockBlock / Course / Teacher
Please sign / Attendance / Academics / Behavior*
If not satisfactory, please provide an explanation below.
1 / Number of absences: / Current Grade: / Satisfactory
Not satisfactory*
2 / Number of absences: / Current Grade: / Satisfactory
Not satisfactory*
3 / Number of absences: / Current Grade: / Satisfactory
Not satisfactory*
4 / Number of absences: / Current Grade: / Satisfactory
Not satisfactory*
*Behavior: ______
Additional information you would like to be considered: ______
______
Thank you for your support of the Job Shadow Program and for taking the time to complete this form. Your recommendations/comments are vital to making this program a success.
Sincerely,
Wendy Roberson
HCEC Career Development Coordinator
Job Shadowing Application: Fall 2018