Cardinal For the Day - Request Form
We are excited to have the opportunity to share our school with your child for the day. We offer full day or half day shadow opportunities. Shadows are available to rising 9th, 10th and 11th graders. You can find additional information on our shadow program on our website under admissions.

In order to facilitate the shadow please submit the form below. Please allow 3-5 days for follow up confirmation from our Admissions team. We want to make sure we are meeting the needs of your child, pairing them with either their requested student host or a student of similar interests to make sure that their shadow is a successful one! Once submitted our Admissions team will find a day that works and will email you confirmation as well as the permission slip.

Please select dates in mid-January and beyond as early January is booked.

If you student needs medication or a medical procedure during the school day--please contact the school nurse at least 1 business day prior to your student shadowing with the doctor's orders or medication forms. Medication needs to be brought by the parent to the clinic the morning of the BI visit-not sent with the student. This procedure also applies to epipens and inhalers. Thanks for your cooperation. Bishop Ireton School Nurse is Donna Lorge, RN at 703-212-5157 or lorged@bishopireton.org

Should you have any questions, please send an email to wilkinsonv@bishopireton.org or call 703-751-7606.

Email address *
First Name of Student:
Your answer
Last Name of Student:
Your answer
Student's Home Address:
Your answer
Student's City:
Your answer
Student's State:
Your answer
Zip Code:
Your answer
Student's gender:
Current Grade Level of Student:
Current School of Student:
Your answer
Are you interested in a full day or half day shadow?
What are your areas of interest? Please be sure to be specific. If your interests are in sports, please list the sport. If your interests are in music, please list the instrument or voice. If you are specifically interested in an academic subject, please list the subject. The more information we have the more closely we can match you up with a host.
Your answer
Do you know someone at Bishop Ireton that you would like to request as your host? We cannot guarantee their availability but will certainly make an effort as the first choice.
Your answer
Please note 3 potential dates that work for your shadow opportunity. Date option 1:
MM
/
DD
/
YYYY
Date option 2:
MM
/
DD
/
YYYY
Date option 3:
MM
/
DD
/
YYYY
Is there anything we should know about your child during their shadow visit?
Your answer
Does your student have any allergies we should be aware of?
Your answer
First Name of person completing this form:
Your answer
Last Name of person completing this form:
Your answer
Email address of person completing this form:
Your answer
Best phone number for person completing this form:
Your answer
Relationship to student:
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Bishop Ireton HS. Report Abuse - Terms of Service