Job Shadow Packet
Rubric:
Unsatisfactory – 0-1
Planning & Contact The site was not approved
before contacting. Initial
contact with an organization
was not documented. OR
Student required extensive
assistance to initiate contact.
Permission Form & Permission form was not filled
out and turned in. No
Supervisor Signature signature was obtained from
the supervisor OR time at
shadow experience was not
documented.
Experience Notes No to limited experience
notes were taken.
Reflection Reflection does not meet
2-page (double-spaced)
minimum, has 10+ spelling
and/or grammar errors, or
shows minimal effort.
Thank You Note No thank you note was turned
in.
Planning & Contact ____ / 4
Permission Form ____ / 4
Experience Notes ____ / 4
Reflection ____ / 4
Thank You Note ____ / 4
Good– 2-3
The site was approved and
initial contact was
documented. However, the
student required some
assistance to initiate contact.
*Documentation can be in
form of email, phone call, or
writing. Email and phone call
may be an uploaded
screenshot or printed off.
Permission form is missing
one signature OR the
permission form was not
turned in 5 school days in
advance. Student obtained
signature and time
documentation from the
supervisor at the shadow
experience.
Some experience notes were
taken but they lacked detail.
Notes include at least one
student-developed question.
Reflection meets 2-page
(double-spaced) minimum,
has fewer than 10 spelling
and/or grammar errors, but
does not include a reflection
of the student’s experience,
how the occupation may fit
into the student’s future, etc.
A handwritten thank you note
was turned in, but longer than
1 week after the job shadow.
Total
Excellent – 4
The site was approved before
contacting, initial contact was
professional, and initial
contact was documented.
Student set up shadow
experience on their own.
*Documentation can be in
form of email, phone call, or
writing. Email and phone call
may be an uploaded
screenshot or printed off.
Permission form has all
required signatures and was
turned in 5 school days in
advance of the scheduled
experience. Student obtained
signature and time
documentation from the
supervisor at the shadow
experience.
Thorough experience notes
were taken that provide an
understanding of the
occupation and its workings.
Reflection meets or exceeds
2-page (double-spaced)
minimum, has fewer than 5
spelling and/or grammar
errors, and reflects thoroughly
on the student’s experience,
how the occupation may fit
into the student’s future, etc.
A handwritten thank you note
was turned in within 1 week
of the job shadow.
____ / 20
Experience Note Prompts and/or Reflection Questions
What are your responsibilities?
What schooling or training did you have to do to qualify for this job?
What do you find to be the most rewarding part of this job?
Are there particular skills that come in handy for this job?
What types of things have come as a surprise to you in this job?
What subjects would be beneficial for me to study now?
What are the benefits of this job?
What is the biggest drawback of this job?

What surprised you most about your experience?

What is the most important thing you learned?
Will you consider a career in this field? Why or why not?
What did you like the best/least about your experience?

Signature & Time Documentation from Supervisor

________________________________________ ___________________
Signature of Supervisor Date

Time participant arrived _____________ Time shadow experience ended _____________

Permission Form
— — — — — — — — — — — — —

I grant permission for ___________________ to attend a job shadow on ___/___/20__ from

___:____ am/pm to ___:____ am/pm. I understand that they are responsible for completing any
missed work and assignments that may occur during their shadowing experience. I agree to
provide or arrange transportation to and from the experience site for my student. I have read all
provided materials about job shadowing. I understand that XYZ School and Ms. Lutjelusche
assume no responsibility for health, accident, or transportation insurance while my student is out
of school for their job shadow experience. If you have any questions please contact Ms.
Lutjelusche at 402-910-7501.

________________________________________ ___________________
Parent/Guardian Signature Date

I ___________________ agree to attend my job shadow on ___/___/20__ from ___:____

am/pm to ___:____ am/pm. I understand that I am responsible for completing any missed work
and assignments that may occur during my shadowing experience. I understand that by
attending this experience, I am representing the XYZ School and will act responsibly, safely, and
kindly during my job shadow. I understand that XYZ School and Ms. Lutjelusche assume no
responsibility for health, accident, or transportation insurance while I am out of school for my job
shadow experience. If you have any questions please contact Ms. Lutjelusche at 402-910-7501.

________________________________________ ___________________
Student Signature Date