Student Information

*  indicates required

Student Name: *

Nickname:

Current School: *

Current Grade: *

Address: *

City: *

State: *

Zip Code: *

Home Phone: * (eg, 317-555-5555)

Parent Contact Information

Parent Name: *

Daytime Phone: *

Evening Phone: * (eg, 317-555-5555)

Email address: * or enter 'NA'

Selecting a Day to Shadow

Please indicate your first, second and third choice below.

First Choice: *

Second Choice: *

Third Choice: *

Shadowing at BCHS begins on Mon, Sept. 20, 2010 and continues until Dec. 9, 2010. Due to school acitivites, some dates during this time are not available. Click on the calendar icon to view and choose an available date (Available dates are a darker blue color).

First Choice: *

Second Choice: *

Third Choice: *

Who would you like to shadow?

All 'shadows' are paired with one of our Freshman Ambassadors, who will be the shadow's host for the entire day. Shadows can request a particular host, and if he or she is a Freshman Ambassador who is free that day, we will do our best to pair them up. Students who do not request a host, or who request someone who is not a Freshman Ambassador, will be assigned a host based on academic and extracurricular interests. Please help us pick the perfect host by filling in the following:

Is the student interested in Honors Classes? YES    NO

Is the student interested in shadowing a freshman enrolled in the Academic/Language Support Program?    (Information about this program) YES    NO

Who would the student like to spend the day with:

Student's Extracurricular Interests: