SECONDARY INTERVIEW, SHADOW, TOUR APPLICATION
is a program funded through grants from Gifted and Talented and the Department of Instruction. The focus of the project is to place students with an adult for an interview, a shadow, a tour or a six week mentor program. We will need a minimum of three (3) weeks to process applications. If applications are sent for an entire class of students, it is important to allow a minimum of four (4) weeks.
Student:
Phone:
Address:
Zip: Gender: Male Female Age:
Date of Birth: Grade:
Teacher:
School:
Please schedule by:
Project Completion Date:
Day/dates preferred:
Time preferred:
DO NOT schedule on the following days/dates:
Would you like us to plan: In Person Interview Telephone Interview Shadow (2-4 hour observation) Tour Mentor (6 week minimum)
Describe, as specifically as you can, the experience you want us to arrange in your career or interest area:
What results does student/teacher expect from this interview?:
How will results be shared?:
If you know a friend or parent, someone or some place within your area of interest you would like to visit, please indicate below:
Name:
City: Zip:
You will need to arrange your own transportation. Please remember this when you indicate your preferred time in this space provided. Please talk about transportation. It is integral to the project. Please also make sure to let us know the days and times we CANNOT schedule. Your interview, tour, shadow or mentor appointment will be set with your personal schedule in mind. The volunteer who commits to this effort will be arranging a schedule to accommodate that appointment, so we will not want to cancel. Student, parent and teacher signatures are required. Signatures on the release form also required.
Student Signature:
Parent Signature:
Classroom Teacher Signature:
Click the Submit Button below to send your request to Volunteer Services.
Updated 9/22/2008