Penn State University Student Shadowing

Penn State University Student Shadowing

Name

Phone Number

Email

College/University

Program of Study

Graduation Date

School Contact (name/email)

Penn State Health Entity Location

Preferred department to observe (select 2)

PSH preferred position/staff member to observe?

Number of Hours Requested

Is this required for:

If School Program, Name of Program

Requested Start Dates

Requested End Dates

Requests are reviewed based on department availability and prioritization. Requests must be submitted at least three months prior to the requested start date.

Availability

Mon. 8 a.m.-12 p.m.	Mon. 1-5 p.m.
Tues. 8 a.m.-12 p.m.	Tues. 1-5 p.m.
Wed. 8 a.m.-12 p.m.	Wed. 1-5 p.m.
Thurs. 8 a.m.-12 p.m.	Thurs 1-5 p.m.
Fri. 8 a.m.-12 p.m.	Fri. 1-5 p.m.

Do You Rely on Public Transportation?

Yes

No

Desired Goals or Outcomes of Observation

Additional Information:

Contact Information