DuBois Area High School
Groundhog Day Job Shadowing Permission Form
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DuBois, PA 15801 Job
Phone: (814) 371-8111 Fax: (814) 371-3928 Shadow
. Day!
Students wishing to engage in a job shadowing experience need to complete the following items.
Before job shadowing students must:
a Contact the job shadow site of their choice and fill out the Student Section 1
a Have Parent/Guardian complete Section 2
Qa rnin form istory Teacher by Wednesday, January 22 for preapproval
o 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 fill out the Job Shadowing Supervisor Section 5
a Complete the supervisor interview section on the back
After job shadowing students must:
a Return the fully completed form to History Teacher by Wednesday, February Sth to be granted
an excused absence
a Scan the completed form to their Student Drive when forms are returned to you and save your
original
1: Student Section History Teacher: Mes Woc cS
Student's Name: _Aleyandca Feido avec Grade:_\O
Job Shadow Career: Wledivcal Once acy ckBusiness Name: Wainae Leno 7
Supervisor: DC. Mu itias Phone: (eS ORE 2535
Date of Job Shadow: __January 31, 2014 Time of excusal: __7:45 am __ Time of return: 2:35 pm
I give permission for my daughter/son to be excused for the above job shadowing experience.
Parent's Signature: £77, = Dater_a- Aer Ay
Home Phone: (14-12-1422 Work Phone:_ (B44) - 275-352
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