First Name

Last Name

Student's First Name

Was the student on time for the Job Shadow?
Yes
No

Was the student's attire appropriate for the workplace?
Yes
No

Was the student prepared for the day?
Yes
No
How would you rate the student's interest/participation for the day? Very interested and involved in the Job Shadow experience Somewhat interested and involved in the Job Shadow experience Not interested or involved in the Job Shadow experience

Would you be interested in having another student shadow you in the future?
Yes
No
Please offer any feedback/suggestions that you would like the student to receive:

Please give us any feedback/suggestions that you may have to improve the Job Shadow program:

Thank you for your time.