CCSD Students' Job Shadowing Connection Request Form

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THIS FORM SHOULD BE COMPLETE BY THE CCSD STUDENT REQUESTING A JOB SHADOWING CONNECTION ALIGNED WITH THEIR CAREER INTERESTS.

The information shared in this form will be used to connect you with an opportunity that aligns with your career interest.

BEFORE SUBMITTING THIS FORM, Please ensure you have spoken with your teacher, school counselor, and your parents about this opportunity.

Questions?
Contact your school's Career Specialist or Chad Vail, CCSD Work-based Learning Partnership Coordinator -
chadwick_vail@charleston.k12.sc.us

Student First Name: *

Student Last Name: *

What is the name of your school? *

Please provide the whole name of your school without abbreviations.

What is your current grade level? *

Freshman

Sophomore

Junior

Senior

8th Grade

7th Grade

6th Grade

Other:

Student Date of Birth *

Some career exploration experiences have a minimum age.

YYYY

Student Email Address: *

Student Phone: *

Occupation / Career Interest *

What career(s) are you interested in exploring?

Which career exploration opportunities are most appealing to you? *

Please check all that apply - See descriptions & more info here: https://charlestonempowered.com/work-based-learning/

Solo Job Shadowing (Could be a Zoom chat or work place meeting)

Group Job Shadowing / Structured Worksite Visits (Often with your class)

Career Camps (Often in the summer)

Career & Technology Student Organizations like DECA or HOSA and competitive teams like FIRST Robotics

I am also interested in learning more about internships and / or apprenticeship connections

Other:

Required

What would be your ideal connection? *

What type of business / organization would you be excited to be connected with? And, is there a specific business you have in mind? <EXAMPLE ANSWER> "I would like to learn more about manufacturing and I would like to be connected with a professional at Boeing."

Special Considerations *

Please list any sports teams or other extra-curricular activities that may impact your availability.

What is your transportation plan? *

How will you get to and from your assigned career exploration experience, should it be at a worksite / professional office?

What is your home address? *

Ideally, your career exploration location will be near your school and/or home.

Name of recommending teacher or school counselor? *

Who at your school encouraged you submit this form?

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