Groundhog Shadow Day 2019 - Mentor Registration Event date: Friday, February 1, 2019 Question Title * 1. Company Name Question Title * 2. Company Details Address * Address 2 City * State * ZIP Code * Website Question Title * 3. Mentor Details Host Name Job Title Department Email Address Phone Number Question Title * 4. Dress Code Professional dress - Suit, tie, etc. Business casual - Khakis, dress pants, collared shirt, blouse, etc. Casual - Jeans are acceptable Skilled trades ready - Long pants, closed-toe shoes, etc. Other (please specify) Question Title * 5. Parking InformationTip: Please be specific, teen drivers need detail. Question Title * 6. Are there any special instructions we should know about? Please let us know about anything not included above. Question Title * 7. Are you willing to host media during the event, i.e. newspaper, TV, radio, etc.? Yes No Other (please specify) Question Title * 8. How many students are you willing to host on February 1, 2019?Tip: Best practice shows that hosting a minimum of two students make for a more interactive day. 1 2 3 4 5 6 7 8 9 10 Other (please specify) Question Title * 9. If you were asked to place YOUR ROLE into one career cluster, which would you choose? Agriculture, Food, and Natural Resources Architecture and Construction Arts, Audio/Video Technology, and Communications Business, Management, and Administration Education and Training Finance Government and Public Administration Health Science Hospitality & Tourism Human Services Information Technology Law, Public Safety, Corrections & Security Manufacturing Marketing Science, Technology, Engineering & Mathematics Transportation, Distribution & Logistics Question Title * 10. Write a commercial about what students CAN EXPECT TO EXPERIENCE with you! Please note, this is the most important part of your application. This blurb is what will entice a student to choose YOUR ROLE. The response can be no longer than 250 characters (think Twitter). Question Title * 11. Students will be onsite over the lunch hour. They should plan on:Tip: Due to the high level of free/reduced lunch population in Kent County, providing lunch is strongly encouraged. Lunch being provided by your company Providing their own lunch Question Title * 12. Will you be traveling offsite with your student(s) during the day?Tip: Travel within a company complex does not require a permission slip. Yes No Question Title * 13. Do you have any special requirements for your organization, i.e. need shoe sizes for shoe covers? If so, please indicate details below. LEGAL SMEEGAL Question Title * 14. Please review the guidelines for event participation below and check your agreement to each statement: I understand that the students will be onsite at my company from 9:00 AM until 2:00 PM on February 1, 2019. I understand that students should remain onsite and not travel unless prior arrangements have been made with Kent ISD and students. If you'd like a student to travel with you, we are happy to get a permission slip from parent/guardians. I understand that the students will not be compensated by my organization for this experience. I understand that Kent ISD provides liability insurance coverage for the student while assigned to your facility/office, as does the student’s home school. I agree to the Employer Information and Safety Guidelines. Please read. (Once done reading, please use the BACK ARROW to return to your form, otherwise the data may be cleared.) Done