Intern Interest Form

Intern Interest Form
General Information
Business Name*
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Industry Type

AgricultureEducationHealthcareManufacturingTechnologyOther
How many employees work at your business/organization?

Fewer than 1010-4950-99100-499500+
Internship Interest and Experience
Has your business/organization ever hosted internships?

YesNo
If yes, were those internships paid or unpaid?

PaidUnpaidBoth
What age would your business/organization consider hosting internships for young adults in the future? Mark all that apply.

14-1516-1718-21
Internship Preferences
What type of tasks or roles would be assigned to interns? Check all that apply.

Administrative SupportCustomer ServiceEducation AssistantCreative tasks (ex graphic design, marketing)Technology-related tasks (ex. coding, IT)Labratory WorkManual LaborProject ManagementScientific ResearchOther
What schedule flexibility would you require for interns?

Full-time (30-40 hours/week)Part-time (10-20 hours/week)Flexible hours
What is the ideal duration of an internship for your business/organization?

4 weeks8 weeks12 weeksOther
What level of supervision or mentorship would be provided to the interns?

Minimal Supervision (independent tasks)Moderate Supervision (regular check-ins)High Supervision (close mentorship and guidance)
Compensation and Support
What is your preferred hourly wage range for an intern?

$11.25-$14/hour$15-$20/hourOther
Would your business/organization require any financial support to offer paid internships?

YesNoUnsure
What additional resources or support would encourage you to host interns? Check all that apply.

Training for supervisorsLiability insurance supportGuidance on creating internship projectsOther
Barriers and Challenges
What are the biggest challenges your business/organization faces in hosting interns? Check all that applies.

Budget limitationsLack of staff to superviseConcerns about legal or liability issuesLimited availability of meaningful tasks for internsOther
What concerns, if any, do you have about offering internships to youth aged 14-21?
Additional Input
Are there specific skills or qualifications you expect youth interns to have?
Would you like to participate in a follow-up conversation about this topic?

YesNo
Additional comments or suggestions regarding you internship programs?
Should be Empty:

Intern Interest Form

General Information

Internship Interest and Experience

Internship Preferences

Compensation and Support

Barriers and Challenges

Additional Input