Child Life Shadow Opportunity

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:*

Select

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

Select

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

Select

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

Select

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

Are you a US Citizen*

Select

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.

Drag and drop files here or

Send me a copy of my responses