QMC Shadow Day Request Form
Welcome! Please complete the form below to request a shadow day. We strongly encourage all interested students to shadow before submitting an application. 

All shadows should arrive between 7:45 and 8:00 A.M. and plan to stay until dismissal time at 3:00 P.M. Please make sure transportation is arranged for the shadow date as QMC is unable to provide transportation.

QMC is located on the campus of CT State Community College Quinebaug Valley (CSCC), formerly Quinebaug Valley Community College. Use 742 Upper Maple Street, Danielson, in your GPS.  To arrive at the correct entrance, on campus you will take a right at the first stop sign and proceed straight.  QMC is the building attached to the right-hand side of QVCC with solar panels on the roof.

All shadows are able to get breakfast and lunch for free. You are also welcome to bring lunch from home if you prefer. Please bring a water bottle for drinking water during the day.

After this form is submitted, the Main Office will reach out to set up a day for your shadow. If you have additional questions about shadowing at QMC please call QMC's Main Office at 860-932-4040.

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Student's First Name: *
Student's Last Name: *
Gender Pronoun: *
Today's Date *
MM
/
DD
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YYYY
When would student like to Enroll? *
Student's Preferred Pathway: *
Student's Current Grade-level in 2023-2024: *
Student's Current School: *
Student's Town of Residence: *
Parent/Guardian's Name: *
Parent/Guardian's Phone Number: *
Parent/Guardian's Email: *
Thank you!
Please reach out to our Administrative Assistant, Neida Rosado at nrosado@eastconn.org for more information! 
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