DuBois Area High School “Job Shadowing Permission Form “25 One rene Dube Pa 1s801 Phone: (4) SOL Fae (044) 374-3928 ‘Sudents wishing to engage In a job shadowing experience need to complete the following items. Before job shadowing students must: {© Contact the job shadow site of thelr choice and fil out the Student Section, Section 1 {2 Have their parent/guardian complete Section 2 12 Take the form tothe attendance office for notification and approval, complete Section 3 ‘0. Please note: ‘= Students will only be excused to visit the same site/career once a year. Students will not be excused If they have missed 10 oF more school days. During job shadowing students must: {a Have their job shadow supervisor fil out the Job Shadow Supervisor, Section 5 | Complete the supervisor interview section on the back ‘After job shadowing students must: 12 Scan the completed form to their Student Drive for thelr electronic portfolio and save the original copy ‘Students are responsible for maintaining this record, copies are not kept atthe school Superior: i Date of Job Shadow: PY YUE CO Time of excusal: Bier 2: Parent/Guardian Section {ve permission for my uhteson to be excuspd forthe above jb shadowing experience. Parent's stonature: A zcliica Zee pate \Q) Home Phone: a= U8 Work Phone: 2] SS OCO_ 3: Attendance Offices certify that this student reported thel Continued on Back1. Would you be wiling to participate asa job-shadowing supervisor for other students? ys) 2 Ifyes, do you have a business card and/or any other information that we could add to our job shadowing directory? i Ye Clay kG of 2 No 3+ What are the most important sls stulent need to obtain before applying f ob in your eld? 7 ‘+. Tp there anything that we can do to make this experience more effective or beneficial? To be completed at the job shadow site by Student rvisor iew ‘She Gera, ane {Cu ring: Seraay WHER Sima tree Pedy Scrence ind Sociay Sauclies Cae SES OU SOUT I nt dee ec thing ii 5 ear ae fel are essen for suce&sa th this RANG? a src ave ul het dba tr pubis patel Aid hao? O ste Tous’ "Fea neal] {nem ro wine tay Get ir, th ed ds is qoud td tor * moticer a ae en ee oxtnninstettee Won yo Ol hoe erent 10, What i the fata jb outlook? Thay Wave Cust uw a steerer ori 12. Do, yp know a i cohen bel Sir + ihe t C Ve OS RG at auct abou 4eaching snowDuBois Area High School Groundhog Day Job Shadow Permission Form 425 oneneAvenv Groundhog ib Staion Dubos, PA 15601 Prove! (61s) 375-0181 Fan: (@44) 374-2928 Day ‘Students wishing to engage in a job shadowing experience need to complete the following items. Before job shadowing students must: ‘2 Contact the job shadow site of their choice and fil out the Student Section 1 ‘a Have Parent/Guardian complete Section 2 a Tum in form to History Teacher by Friday, January 23 for preapproval © Please note: + Students will not be excused if they have missed 10 or more school days. + Students may not visit the same exact site and career more than once, During job shadowing students must: ‘a Have their job shadow supervisor fil out the Job Shadowing Supervisor Section 5 a Complete the supervisor interview section on the back After job shadowing students must: 1a Scan the completed form to their Student Drive when forms are returned to you and save your coriginal - NO COPIES WILL BE KEPT BY SCHOOL STAFF ry student's Name: (U/L sunt rede: _1 3 shadow Career: 2 ih Business Name: Supervisor: 5 Phone: _F// Date of Job Shadow: _ February 2, 2015 Time of excusal: _7:45 am__ Time of retu: 2:35 pm 2:Parent/Guardian Section 1 give permission for my daughter/son to be excused forthe above job shadowing experience Parent's Signature: <<. Ct Primary Phone: ‘SL DAHS Office Section: ‘Approved job shadow experience ‘Official Signature: Te mpl i isor on the day of the shadow ba D3 gate: © 00 IAM serene 300 ON Stanature of Supervisor: —‘The DuBois Area School District would liki'to thank you for providing our etudents with this job shadow experience f you would be willing 0 pattiipate as a job-hadow supervisor for other studenis please ‘mail the following information tothe Job Shadow Day Coordinator, Mrs. Rosary Pennington at wemaingson@lisd kizpans g wets y Saye First and Last Name arbara Edber VY SO3-$03:| Business Name and Job Tide IY ge by Balad PhoneNinber vis3¢0 yarn (on Pease let us now if there anything iat we ca do toe ths experience more ete or beneficial? To be completed at the job shadow site by Student Supervisor Intervi 1. How did you become interested in this eld T Lite lw! e 1ng, With peorie and Fought Whisperer dian Gay) uy mt 2. 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