Leadership Tomorrow Host Agency Application
Please note that this form cannot be saved; it must be filled out and submitted in one session. Contact Sierra Debrow, sierrad@jewishkc.org, with any questions.
General Information
Agency/Organization
*
Contact
*
First Name
Last Name
Title
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor Information
Name (If different than above)
First Name
Last Name
Title
Department
*
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Number of years at agency
*
Have you had previous intern supervision experience? If so, please describe.
*
If no, type "N/A"
Agency Information
Mission
*
How long has the agency been in operation?
*
How many staff members does the agency have?
*
Internship Information
What department will the intern be working in?
*
What field is the internship in?
*
Example: fundraising, marketing, volunteer engagement, etc.
Please describe the intern's projects/responsibilities:
*
What skills/experience will the intern gain?
*
What involvement will the intern have with the agency overall?
*
Will the intern be expected to work outside of normal business hours? If so, please explain.
*
If no, type "N/A"
What is your organization's current protocol for COVID-19
*
If necessary, is your organization able to host an intern virtually?
*
Submit
Should be Empty: