Child Life Shadow Opportunity

Full Name

Email Address:

Age:

Participants must be at least 16 years old on the day of the Shadow opportunity.

Birthday:

If you are currently enrolled in school, please provide your school's name

Please indicate which campus you would be interested in shadowing:

Please share what date(s) are you interested in:

What 3 Hour Timeframe are you interested in:

Please specify a 3-hour timeframe between 9:00 AM and 3:00 PM that you are available to shadow

Have you traveled outside of the US in the last 3 months?

If you answered yes, please indicate what countries you visited in the next section

Please list the countries you visited and the dates you returned to the US:

Are you a US Citizen

One Day Observation Health and Confidentiality Form

Please fill this form completely and upload in the next Section
If Shadow Occurs between October 1st - April 1st, please provide a copy of a Flu Vaccine Documentation.

Applications will not be considered if the required documents are not included.

Drop your files here

Send me a copy of my responses