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Shadow Request Form


Student name (first and last name)

Student address
            City      State    Zipcode

School currently attended


Grade  8th      9th       10th        11th

Has the student ever been enrolled at IWHS?   Yes        No

Date requesting to visit:    A. First choice          B. Second Choice 

Guardian's name
           Telephone number 
           Email address 

What are her extracurricular interests? Please select two preferences. (Select one and hold the CTRL key down to select a second.)


Please list all the clubs or organizations in which the student is currently active.


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