Job Shadow Contract

Student Name: ________________________ Age: ________

Home Address:	________________________________________________
	(Street, City, State, Zip)

Phone: ________________ Social Security Number: ________________

Home School: ________________________ Career Coach: ________________________

Transportation Arrangements: __________________________________________

_________________________________________________________________

Career(s) Being Shadowed: __________________________________________

**************************************************************************************

Employer: ________________________

Contact Person: ________________________

Address:	________________________________________________
	(Street, City, State, Zip)

Phone: ________________ Date: ____________ Time:	_________/________
	(From / Until)

*****Signatures of Persons Approving this Job Shadowing Experience*****

Employer:
Will provide the student the opportunity to learn more about the professions at the worksite.

Name: ________________________ Date: ____________

Parent/Guardian:
Approves their student participating in the Job Shadowing experience and will assist the student in researching and planning the experience.

Name: ________________________ Date: ____________

Student:
Will abide by all the regulations and policies of the employer and the school while planning and participating in this Job Shadowing experience.

Name: ________________________ Date: ____________

Career Coach:
Will coordinate this Job Shadowing experience with employer contact and student planning process.

Name: ________________________ Date: ____________

Phone: ________________ Fax: ________________

Copies to: u White-School Permanent File u Pink-Employer

u Yellow-Career Coach u Gold-Student Evaluation Form for EDP