Internship Interest Survey (Business)
Company/Organization
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Industry/Business Type
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Company/Organization Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your business registered with the Virginia State Corporation Commission (SCC)? If so, please list your business' registered name if different than your Doing Business As (DBA) name above. If not, please explain why.
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How many employees does your business have?
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Point of Contact Name
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First Name
Last Name
Point of Contact Title
Point of Contact Email
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example@example.com
Point of Contact Phone Number
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Please enter a valid phone number.
Have you hosted interns before?
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Yes
No
Number of positions you can host:
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Pay Amount
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Minimum $12/hr
Please choose all options that best describe your company:
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We are able to pay the full amount of the internship stipend (Min. $12).
We would like information on possible matching funds resources in our area (50%).
We are unable to pay an intern. We would like to offer an unpaid internship only.
What schedule should the student expect to work? (Dates, time period, times, etc.)
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Please be as detailed as possible.
What department will this internship opportunity be in? What is the title of the opportunity?
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Please be as detailed as possible. Ex. Marketing Dept., Social Media Intern
Eligibility requirements (age, skills, interests, etc.)
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Please be as detailed as possible.
What age group are you willing to work with?
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16+ High school students only
18+ College Students only
Either/Both is fine
General description of internship opportunity (duties/responsibilities, application process, expectations, etc.)
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Will any certifications be required of the intern? (Ex. CPR/First Aid/AED certification, industry certifications, etc.) Please specify whether these credentials will be provided by your business or not. Type N/A if not applicable.
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Do you offer any other support for interns such as housing, transportation, uniform assistance, etc.? Type N/A if not applicable.
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Please select the primary career cluster for this opportunity:
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Agriculture, Food, and Natural Resources
Architecture and Construction
Arts, Audio and Video Technology, and Communications
Business Management and Administration
Energy
Finance
Government and Public Administration
Health Sciences
Hospitality and Tourism
Human Services
Information Technology
Law, Public Safety, Corrections, and Security
Manufacturing
Marketing
Science, Technology, Engineering, Mathematics
Transportation, Distribution, and Logistics
Other
Do you have a particular student(s) in mind for an internship already? If so, what is the students' name(s) and school(s)?
Is there a special link that you want to include in the posting?
Are there any special documents or flyers you would like to include in the posting? (optional)
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Point of Contact Signature
*
Submit
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