CSI Student Shadow Request
Thank you for your interest in the Utica Center for Science and Industry. Many prospective students have found that a visit to the center during a school day helps them to better understand the unique qualities that our program offers to it's students.

Visits can be scheduled Monday - Friday most weeks. When choosing a day to visit, please choose a day at least four school days out from today. Shadow requests will be filled from 10/15/2019-03/15/2020. To ensure a quality experience, we limit the number of student shadows on a given day. The following dates are currently unavailable: 2/13, 2/17-2/21, 2/25, 2/27

On the day of your visit, please plan on arriving at the Instructional Resource Center (14201 Canal Road; Sterling Heights 48313) between 7:30 am and 7:40 am. You will enter through the center doors of the building and ask for Mrs. Struck or Mr. Paulon. You will be paired with a CSI student that you will shadow for the duration of the morning class times, ending at 10:30 am. Students can then be picked up by their parents or take a UCS bus to return to their school for the remainder of the day (NOTE: there is NO BUS that travels to BEMIS at 10:30, so all Bemis students must arrange parent pickup). Please have your parents contact your current school to make them aware of your excused absence.

Please carefully complete the following form and Mrs. Struck (MST counselor) or Mr. Paulon (program administrator) will contact you within a week to schedule your visit.



Student's first name *
Your answer
Student's last name *
Your answer
Student's email
Your answer
Current grade *
Current school *
Current math class *
Parent(s) or guardian(s) names *
Your answer
Parent or guardian email *
Your answer
Parent phone number *
Your answer
Alternate parent phone number
Your answer
What day works best for you to visit CSI? Please choose a day at least four school days from now. These dates are FULL and UNAVAILABLE for shadows: 2/13, 2/17-2/21, 2/25, 2/27 . If you have the ability to drop your child off at 11:05 am and pick him/her up at 1:40 pm, I could schedule an afternoon shadow. Please indicate that in your answer. *
Your answer
Please select a backup day to visit CSI *
Your answer
Do you have any questions you would like answered prior to your CSI shadowing experience? *
Your answer
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