Brother Rice Shadow Day Form
You will receive a confirmation email prior to your shadow day. Please contact Mr. Frasor with any questions at bfrasor@brrice.org or 773-429-4351
Shadow Day or Family Campus Visit *
Student First Name *
Student Last Name *
Address *
City *
State *
Zip Code *
Current School *
Current Grade *
Required
Parent/Guardian Email Address *
Home Phone Number *
Parent/Guardian Cell Phone Number *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Shadow Birthdate
MM
/
DD
/
YYYY
Please check ALL the activities you are interested in. *
Required
Student Allergy/Accommodations
Please list any allergies or accommodations that your son may need during his visit.
Shadow/Visit Day Choice *
Dates NOT available to shadow: 1/20/2020, 2/24/2020, 3/13/2020, 4/3/2020 and 4/9 - 4/17/2020.
MM
/
DD
/
YYYY
Brother Rice Host Request
Fill in the name of a current Brother Rice student you would like your son to shadow. (Not Required)
Parent/Guardian eSignature *
My son has my permission to spend the day at Brother Rice High School as a guest on any of the above chosen dates. I understand that he will abide by all the rules and regulations of Brother Rice High School. I have contacted his grade school to inform it that he will not be in school on the day of the visit. I can be reached at the phone number above in case of an emergency.
Signature Date *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This form was created inside of Brother Rice High School.