Host Company Registration For WELL

Host Company Registration For WELL

Please complete this form to register your company as a host for the WELL international training or internship program.
Company Information

Provide your organization's general information.
Company Name*
ABN or ACN
About Your Company
Company Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Industry*
Name of CEO
Annual Revenue (in AUD $ or local currency)
Number of Full-time Employees
Company Website URL
Most Commonly Used Language
Contact Person (Supervisor)

Who will supervise the trainee/intern at your company?
Contact Name*
Title
Phone Number*

Area CodePhone Number
Email
example@example.com
Job Description

Details about the training or internship position.
Training Site Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Position Title*
Expected Number of WELL Participants
20% of Full-time Staff Number
Required Education
Required Experience
Required Language and Level*
Main Responsibilities
Other Requirements (if any)
Benefits

Outline the benefits and work conditions for the trainee/intern.
Stipend (if applicable)
Work Experience Hours per Week
ex) 30-38 Hours
Other Benefits (if any)
Additional Information

Provide any extra details or requirements.
Required Documents (to be submitted by trainee/intern)*
Remarks
Company Registration

Cancelof
Signature

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