OPT-In Employer Application Form

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Thank you to our partners!The OPT-In Internship Program is designed to connect recent high school graduates with local businesses, creating opportunities for hands-on experience and professional growth. Together, we can build stronger businesses and brighter futures in our community!
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Name of Company Applying* This field is required.
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What does {nameOf} do?* This field is required. What services do you provide?
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What industry are you a part of?* This field is required.Please select all that apply.
Manufacturing
Social/Human Services
Food Service
Construction
Healthcare
Education
Public Services
Agriculture
Technology
Local Government
Non-profit
Business
Finance
Other
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Are you able to compensate your intern(s) at the rate of $14.00 an hour for their time at their worksite and in professional development classes?* This field is required.
YESNO
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Would providing your intern(s) with a work stipend through our WORC Grant enhance your ability to offer young people meaningful work opportunities to explore, gain work experience, and learn about employment opportunities in Burke County?* This field is required.
YESNO
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Cost* This field is required.We are privileged this year to have funding to cover the full cost of wages ($14/hr) for one intern per site for approximately 25 interns, provided federal funding remains in place. You may accept this benefit or choose to cover some or all of the cost of wages. The partial cost of wages for the 8-week experience, excluding the hours of paid professional development is $3,584. The full cost of wages for one intern is $4,480.
I accept the benefit of one fully paid internship.
I accept the benefit of one fully paid internship and want to pay out of pocket for additional interns.
I decline the benefit of one fully paid internship and want to pay $3,584 per intern to cover PART of the cost of wages.
I decline the benefit of one fully paid internship and want to pay $4,480 per intern to cover the ENTIRE cost of wages.
I accept the benefit of one fully paid internship and am able to receive additional interns ONLY IF the cost of wages are covered.
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How many interns can your company accommodate this Summer?* This field is required.Please remember to take into consideration your response to the previous question regarding cost.
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Are you able to compensate each intern at the rate of $14.00 an hour for their time at their worksite and in professional development classes?
YESNO
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Would you like to apply for funding from the WORC grant to help cover wages for more than one intern for the summer? These grant funds are only available for non-profits, small businesses, and government agencies. If yes, you will be required to fill out an application for funding, which will be sent to you after we receive your application.
YESNO
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Will you be participating in the Construction Fast Track program?* This field is required.The Construction Fast Track program is for construction and trade based companies participating in the OPT-IN summer Internship program. Please reach out to us if you have any questions about this program or would like to learn more.
YESNO
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Name of primary point of contact* This field is required.Who should we reach out to if we have any questions?
First Name
Last Name
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What is {nameOf4}'s title?* This field is required.
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What email should we use to reach {nameOf4}?* This field is required.
example@example.com
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What is the best phone number for {nameOf4}? * This field is required.
Please enter a valid phone number.
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Secondary point of contact(optional)
First Name
Last Name
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What is {secondaryPoint}'s title? (Optional)
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What is {secondaryPoint}'s email address(optional)
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What is {secondaryPoint}'s phone number? (optional)
Please include area code.
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What are your operating hours?* This field is required. i.e. How many shifts are available? Are you open on weekends?
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Are you a 501(c)(3) Organization? A 501(c)(3) is a tax-exempt nonprofit organization in the U.S. dedicated to charitable, educational, religious, or similar public-benefit purposes.
YESNO
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My organization is a:
Non-profit Organization
State or Local Government Funded Organization
Small Business (1-49 employees)
Medium-sized Company (50-249)
Large Company (250+ employees)
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How many people does your company employ?Approximate numbers are okay!
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Please list the available positions/areas that OPT-IN interns can rotate through during their 8-week program.* This field is required.A key aspect of this internship is the opportunity for interns to explore every department at their placement, ensuring they gain a comprehensive and well-rounded experience.
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Please outline your hiring process and provide any eligibility criteria for participants. All details shared will be valuable in preparing potential interns for interviews and onboarding.Ex: All applicants must be 18, be able to pass a drug test, have a bank routing number, must provide certain types of id, etc.
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Please list the available benefits that your company offers* This field is required.We want interns to be aware of this information in case they want to apply for full-time employment in the future.
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Please list the entry-level starting wage for your company.* This field is required.We want interns to be aware of this information in case they want to apply for full-time employment in the future.
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Please list the available opportunities for growth, learning, and advancement that your company offers.* This field is required.i.e. training opportunities, tuition reimbursement, promotions, and advancement opportunities
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Please list any other information that you feel would be important for us to know about your company.If none, please skip this question.
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Employer Agreement
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Employer Agreement
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{nameOf} agrees to the Employer Agreement.By signing below, I confirm that I am an authorized representative of the company mentioned above and I agree to the Employer Agreement on behalf of this organization.
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