Name______________________Careers of
Interest______________________________
_______________________________________________________________________
Address_________________________________________________________________
Phone____________________Hours available to visit
mentor________________________
I understand that if I am selected to participate in the
individual shadowing program, I am
responsible for my own transportation, and will be
responsible for making up all assignments missed.
Student’s signature___________________________Date____________________
Parent/Guardian’s
signature________________________Date________________
Please have each of your teachers sign below to indicate
that they are aware of your absence for the upcoming event. They will receive a week’s notice:
Class Schedule
1.
2.
3.
4.
After having obtained the above signatures, please return to
Ms. Donna Donovan, CDC
Career Development Coordinator’s Approval_______________________Date__________