DuBois Area High Schoo! ‘Job Shadowing Permission Form “25 One Avene Dube, Pa 1s801 Phone: (819) 31-8411 Fae: (814) 371-3828 Students wishing to engage in 2 job shadowing experience need to complete the following tems, Befora job shadowing students must: 12 Contact the job shadow site oftheir choice and fll out the Student Section, Section 1 @__Have their parent/guardian complete Section 2 12 Take the form to the attendance office for notification and approval, complete Section 3 © Please note: ' Students will only be excused to vist the same site/eareer once a year Students will not be excused if they have missed 10 or more school days. During job shadowing students must: 2 “Have their job shadow supervisor fil out the Job Shadow Supervisor, Section 5 ‘3 Complete the supervisor interview section on the back After job shadowing students must: a "Scan the completed form to their Student Drive for thelr electron portfolio and save the original copy * "Students are responsible for maintaining this record, coples are not kept atthe school Supervisor: S i 21 Phones: "Date of Job Shadow TV Time of ekcusal AGRA” Tne of retume LP A. ‘2: Parent/Guardian Section Tae emsion omy uence te bv bhadong epee, —_ Parentesionature: A Jcle 2 C72/>/ Home Phone: (2) 23 25-5 10 1k hone ‘3: Attendance Office: ‘Tertty that this student reported thelr pre-aporaved absence. leted by Site isor on the day of ad A: Date: DZ Arrival aime: ‘Signature of Supervisor: Continued on Back‘Woiuld you be willing to participate as ajab-shadowing supervisor for other students? 1 _Yes GED Ifyes, do you have a business card and/or any other information that we could add to oue job shadowing directory? 3s obtain bere applying fora jolyin your eld? ee es cae Is there anything that we can do to make this experience more effective or beneficial? 2 To be completed at the job shadow site by Student ‘Supervisor Interview HES SMUT TAFE ot in nursing coven” 2 NSE ARAN ith Thaic CAONY fiviNg WEA I LI ag Peron exe, B CUMS evtaNAS Wats sedation prpaton for child? Do you recommend certain institution? CORA OTRY ” ofr nla heb high ope r/o son a hi inn yuan? wi Ws CAT " arses oe ee ee one eae ence, NER Wrralparrars, GAs jcindna ss enptnced ave you had that beter prepare you fr your 5 TA GOING) CHUTES GIR TAO) OAT EEONT HOM mat RE CREME 10 SOMONE We What are some duis, and what motivates you to continue his el dyn . ein Pgnience $ ONE OA CCR NS BEB A ING vo wie et Very So 11, What ges af adfannentopprtunies are uaa hil YSELCam COATOUE TAUCAIOTS become MUACSS 12. Do Joutiwgegmparabiejob beste Tsou be xorg this Gel® i wae AUC Si apie a ey hoa in hi el rave DAL OEE al 2 scr ne ging noi 2 BENE MS, YACAKON 2k