Job Shadowing Application

HughM.CummingsHigh School

Thursday, November 29, 2012

Name:
Home Phone: / Age: / Grade:

Job shadowing is designed to allow you to explore a career area in which you are interested. Business people take time out of their busy day to allow students to come and explore their career field, ask questions, and see what a typical day would be like in their career. You must understand the requirements and responsibilities. Students are expected to represent our school in a positive manner while off campus and to prepare themselves for the shadowing day.

Return completed application packet to Mrs. Criss, Room 103 by Friday, October 26, 2012.

No late or incomplete packets will be accepted.

ELIGIBILITY:

  • High School Junior
  • Be in compliance with the attendance policy
  • Have no suspensions
  • Complete and return application packet before the deadline
  • Parental consent

RESPONSIBILITIES (after placement obtained):

  • Attend an orientation session to discuss responsibilities
  • Provide your own transportation
  • Call the shadowing site at least 2 days in advance to confirm your placement
  • Send a thank you note after your shadowing experience
  • Complete a post-shadowing report

I would like to shadow the following job typeor career area (do not list a location here):*

Choice #1:
Choice #2:

*If there is a specific business location or person you wish to shadow, include the information below:

Name: / Business:
How you know this person: / Business Phone:

The Alamance-Burlington School System does not discriminate on the basis of race, sex, color, national origin, creed, disability or any other disadvantaging condition in its educational programs or employment practices.

Job Shadowing Application

HughM.Cummings High School

Thursday, November 29, 2012

First Semester Schedule:

BLOCK / TEACHER / ROOM NUMBER
ADVISORY
First
Second
Third
Fourth

I am aware I must have travel arrangements for Job Shadowing Day to be able to participate. ( ) Student Initials ( ) Parent Initials

Do you currently have a job?( ) YES( ) NO

If yes, where?______

After graduation, do you plan to attend college?( ) YES( ) NO( ) MAYBE

If yes, where?______

How many days have you been absent from school this year?

( ) 0-5( ) 6-10( ) 11-15( ) 16 or more

I understand a completed application does not guarantee placement in one of these areas. I agree to fulfill the responsibilities and requirements associated with participation in job shadowing.

Student Signature Date
Parent/Guardian Signature Date

It can take some time to place students in job shadowing experiences. You will be contacted once placement has been secured. Please do not ask your teachers or administrators about your placements. They will only refer you to me.

This is a great opportunity for you and I look forward to placing you. Please be patient and I will contact you by November 20th with your placement information.

Job Shadowing Application

HughM.CummingsHigh School

Thursday, November 29, 2012

Name: ______

Write a short paragraph describing yourself:

Explain why you are interested in participating in the Job Shadowing program:

Describe your education and career goals:

Job Shadowing Application

HughM.CummingsHigh School

Thursday, November 29, 2012

PARENTAL PERMISSION:

I, ______, give permission for my child,

______, to participate in the Alamance-Burlington School System’s Job Shadowing Program. I have read and understand the requirements for student eligibility. I agree to waive any and all rights to claims against the shadowing site or personnel of the shadowing site, or the school, or any personnel of the school, which may result due to an accident or injury obtained while participating in this program or in transit to or from the shadowing site.

______

Signature of Parent or GuardianDate

PHOTO RELEASE

I agree to allow my son/daughter’s photograph to be taken and used in marketing to promote the Job Shadowing program. I understand my son/daughter’s photo will only be used in a positive manner to inform others about the career exploration activities the Alamance-Burlington School System offers.

______

Signature of Parent or GuardianDate

Return completed application packet to Mrs. Criss, Room 103 by Friday, October 26, 2012.

No late or incomplete packets will be accepted.