Request for Job Shadow Experience

Request for Job Shadow Experience
We are excited that you are interested in job shadowing at Schneck Medical Center.

Please note that you must be at least 14 years of age in order to Shadow at Schneck. If you are under 18 years old, parental/guardian consent is required.

Please complete this online request form and submit. Schneck Human Resources will assist you in making arrangements for your Job Shadow experience. If you have any questions regarding the process, please contact HR at 812-522-0518.
Name of job role or department where you wish to job shadow
Day preference

TuesdayWednesdayThursday
Time preference

8am-noon1-4pm
Proposed Dates
(please list several possible dates that will work with your schedule)
Name

First NameLast Name
Age
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Reason for job shadow request
Are you currently a student?

YesNo
If yes, please list name of school, grade and major (if applicable)
Should be Empty: