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    20160511130139557 1

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    DuBois Area High Sc! ‘Job Shadowing Permission Form “425 Onent Avene Oxaols PX 1SH01 Phone: (14) 3748411» Fax (844) 3713928 ‘Students wishing to engage in a Job shadowing experience need to complete the folawing items. Before job shadowing students must: 1a Contact the Job shadow site oftheir choice and fil out the Student Section, Section 1 18. Have their parent/guardian complete Section 2 Take the form to the attendance ofice for notification and approval, complete Section 3 ‘9 Please note: ‘Students will only be excused to vist the same site/career once a year. + Students will not be excused ifthey have missed 10 or more school days. During job shadowing students must: 1a Have thelr 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 their electronic portfolio and save the original copy ‘+ Students are responsible for maintaining ths record, coples are not kept at the school Wel 5 : u Ge hie Wai ta cae Se haar 2: Parent/Guardian Section 1 give permission for my daughter/son to be excused forthe above job shadowing experience. 2s date:_ W/o /@ Work Phone: = SAC T certify that this student reported thelr pre-approved absence, Attendance Office Sionature: = ‘To be completed by Site Supervisos ‘SiJob Shadow Supervisor Section: ate: 4/ LOM spivatrtine: Co’ 06 ‘Signature of Supervisor: Continued on Back 1. Would you be willing to participate asa job-shadowing supervisor for othe stints? 1 Yes 2 No 2 Ifyes, do you have a business card and/or any other information that we could ad to ove job shadowing directory? 1. Yes

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