Summer RISE 2021: Career Experience Host Registration
Thank you for your interest in hosting Montgomery County Public Schools (MCPS) Summer RISE students either in-person, virtually or a combination of the two experiences. We are very excited to be partnering with you.

By completing this registration form, you are agreeing to be a business, organization, agency or entity (the "Career Experience Host") and a Career Experience Host’s designated staff member(s) (the "Career Experience Host Designee"), as described in the below mentioned Agreements, for one or more MCPS high school juniors or seniors, for up to 4 weeks from Monday, July 5 through Friday, July 30, 2021. It is suggested that you host at least two students for 8-30 hours per week and no more than 8 hours a day for a total of 40 hours up to 4 weeks.

Email from the Summer RISE program organizers will be our primary method of communication along with posted updates on our website: www.MCPS-SummerRISE.org. Please make sure that the email you submit is the one you want MCPS to use to provide updates on the Summer RISE program. Please also make sure you have read the Summer RISE 2021 Host and Designee(s) Agreement (http://bit.ly/HostAgreement2021) and the Summer RISE Parent/Guardian and Host Agreement during COVID-19 Addendum (https://bit.ly/SummerRISECOVID19Addendum) before submitting this form.

Should you not be able to complete this registration form all at once, complete the required sections (noted with the red asterisk) and press the submit button. You will be emailed a link you can use to return to the registration process at a later time.

Each Summer RISE industry opportunity requires a separate registration. If you/your organization are hosting more than one 40-hour opportunity in an industry (such as one 40-hour marketing student and one 40-hour IT student), contact the Partnerships Unit at 240-740-5599 to help with the registration process.

Questions? Email or call Davida Gurstelle at Davida_Gurstelle@mcpsmd.org or call 240-740-5599.
Email *
Career Experience Host Name (Company/Organization) *
If MCPS, write "MCPS-Name of Organization" (ex."MCPS-Budget Unit" or "MCPS-Redland MS")
Company/Organization Mission
Company/Organization Website
Type of Company/Organization *
Number of employees *
Type of industry your company/organization most represents. *
Host Designee First Name *
Host Designee Last Name *
Host Designee Title *
Host Designee Office Number *
Host Designee Cell Number
Please note that this will only be used for an urgent matter.
Alternate Host Designee First Name (if you, the primary host, anticipates being unavailable on any given day or time from July 5th-30th, please provide information for an alternate contact who will be in charge of your student(s).)
Alternate Host Designee Last Name
Alternate Host Designee Title
Alternate Host Designee Email
Alternate Host Designee Office Number
Alternate Host Designee Cell Phone
Please note that this will only be used for an urgent matter.
Street Address (if in-person, the location of where the student will be hosted, and if virtual, the address of your office) *
Suite/Room Number
City *
State *
Zip Code *
Summer RISE Information
Have you hosted a Summer RISE student in previous years? *
If no, how did you hear about Summer RISE (e.g. specify newsletter, person, organization, etc.)?
Were you a Summer RISE Career Experience Host Designee in 2019? *
If you were a Summer RISE 2019 Career Experience Host and are offering an in-person opportunity, has any of the following changed that would require a site visit?
Would you be offering students, in-person, virtual or a combination of the two? *
Students will have access to a Chromebook, internet connection and the Google Suite. Do you anticipate requiring other technology needs for your opportunity? *
If yes, please explain the need and if your company can support the need or if you need to discuss this with us.
What industry is the student opportunity most related to? *
If there are additional industries that the opportunity will include, select the next main industry that will be covered. *
If there are additional industries that the opportunity will include, select the next main industry that will be covered. *
Is your Summer RISE opportunity a shared model? (A shared model is where different departments or staff host students on different days over the course of the Summer RISE experience.)
Clear selection
If you are a shared model, which of the following departments are participating?
How many students would you like to host for this opportunity? Each full month industry opportunity requires a separate registration. Contact the Partnerships Unit to duplicate your registration or with questions. *
Are you willing to host a student who is undecided in their career?
Clear selection
If we can match you with a bilingual student, which language(s) would be preferred?
Please describe what the student will learn and experience as it relates to your career opportunity. *
What job(s)/skill(s) might the student(s) learn about through this opportunity? *
Would your company/organization be willing to make a philanthropic contribution to the Montgomery County Public School Educational Foundation, Inc. which is a 501(c)(3) nonprofit Maryland corporation to help pay for the educational components of Summer RISE program costs? Click here to provide a gift/contribution and learn more about sponsorship levels: https://www.mcpsfoundation.org/pages/our-programs/summer-rise
Clear selection
Confirmation
Electronic Signature *
The Summer RISE 2021 Career Experience Host and Designee(s) Agreement and the Summer RISE 2021 Parent/Guardian and Career Experience Host Agreement during COVID-19 Addendum are on the Summer RISE website at, www.MCPS-SummerRISE.org or can be accessed at http://bit.ly/HostAgreement2021 and https://bit.ly/SummerRISECOVID19Addendum.
Required
Name (First and Last) *
A copy of your responses will be emailed to the address you provided.
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