Job Shadow Application - High School

Thank you for choosing Covenant HealthCare for your job shadowing experience. We have many excellent learning opportunities available. You will be given the opportunity to spend up to a maximum of 4 hours shadowing a health care professional – a professional possessing the expertise to assist you in your future career plan decisions. High school students must be at least 16 years of age in order to participate in this program.

Please complete the application below.

Name
Phone Number
Email Address
Address
City
State
ZIP Code
High School Attending
Grade
Are you at least 16 years of age?

Select top three choices for job shadow placement in order of your preference.

Choice 1
Choice 2
Choice 3
Please describe your interests in healthcare and why you want to job shadow.
List extracurricular activities (include number of years of participation)
By signing in this box, I confirm that I have read and understand the above information. Your name shall have the same force and effect as your written signature.

Signature Date

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