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PIE Shadow Day 2018 Business Registration Form
Please complete the following by Friday, September 21, 2018:
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* Indicates required question
Name of Person Hosting Students:
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Your answer
Name of Business or Organization:
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Your answer
Specific Type of Business:
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Your answer
Street Address:
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Your answer
City:
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Your answer
Zip Code:
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Your answer
Cell Phone Number:
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Your answer
Office Phone Number:
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Your answer
Fax Number:
Your answer
Email Address:
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Your answer
Business Career Clusters
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Please indicate the Career Cluster that most closely relates to your business. Indicating a cluster will help facilitate the student/business match process.
Choose
Natural Resources, Environment and Agriculture (e.g. florist, landscape/nursery manager, veterinarian)
Arts and Communication (e.g. artist, fashion design, graphic arts, interior design, journalism, photography, production design, telecommunications)
Business and Marketing (e.g. accountant, administrative/clerical, advertising, banker, computer applications, insurance, management, marketing, personnel, public relations, purchasing agent, real estate, retail, sales)
Health and Medicine (e.g. dentist/dental assistant, dietitian, hospital administrator, medical/health services manager, medical lab technologist, nurse, optician/optometrist, paramedic, pharmacist, physical therapist, physician, radiologist)
Human Services (e.g. child care worker, cosmetology, educator, firefighter, funeral director, government services, judge/lawyer, law enforcement, military serviceperson, recreation director, social services, youth organization worker)
Technology, Engineering and Science (e.g. architectural/drafting, automotive technician, CAD/CAM operator, computer technician, construction, drafter/design technician, electronics repair, engineer, machinist/manufacturing engineer, printer, utility)
What specific jobs can the student observe with your company?
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Your answer
Number of students you are willing to have observe:
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Your answer
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