FutureSuccess Summer Internship Host
Interest Form
Company Information
Company Name
*
Tax ID/EIN
*
Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website URL
ex. www.aawdc.org
Approximately how many employees does your company have?
*
How many years has your company been in operation?
Are you a Veteran Owned Business?
*
Yes
No
Are you a Minority or Woman Owned Business?
*
Yes
No
Contact Person
Point of Contact Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Internship Placements
How many interns would you want to host?
What is your preferred screening for interns? (check all that apply)
Review resumes
Interview potential interns
We will host anyone you place with us
Other
Will your organization have to run a background check on potential interns before placement?
Yes
No
Have you hosted AAWDC FutureSuccess interns in the past?
Yes
No
Unsure
What year(s) did you host FutureSuccess interns in the past?
Submit
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