Job Shadow Verification

Student’s Name-__________________________________________________________

Date-________________________

Place of Buisness-_________________________________________________________

Contact Person-___________________________________________________________

Phone Number-___________________________________________________________

Please Complete: (To be completed by contact person)

__________Arrival Time _____________Departure Time

__________Was the student courteous and respectful?

__________Was the student prepared with materials and appropriate questions?

__________Did the student record all of the necessary information during the interview and observation?

_______________________________________________

Contact Person’s Signature

FAX return to 346-8746