WLA Internship Registration Form
By completing this form, you and your organization agree to host a WLA Intern on Friday's February 1, 2019 through June 14, 2019. Interns are expected to work at least 4 hours every Friday during the experience to ensure they complete the required 60 hours for their graduation credit.

If, after registering, the ability for your organization to participate changes, then you need to inform the Intern Coordinator (Stephanie Remick: sremick@wlapcs.org) by November 14, 2018.

Organization *
Your answer
Website *
Your answer
Address *
Please list the address where the Intern is to report during Internship February 2019-June 2019
Your answer
Primary Point-of-Contact Name *
First AND Last (NOTE: This person will receive ALL communications about the Internship Program throughout the process)
Your answer
Primary Point-of-Contact Email *
Your answer
Primary Point-of-Contact Phone *
Your answer
Secondary Point-of-Contact Name
First AND Last (NOTE: This person will ONLY receive communications once the final Intern is assigned)
Your answer
Secondary Point-of-Contact Email
Your answer
Secondary Point-of-Contact Phone
Your answer
Please indicate the number of Interns you are able to host. *
Please provide a job description/outline of expectations for the Internship. *
Your answer
What process would you like to follow to conduct interviews? *
Please indicate what, if any, paperwork/on-boarding procedures students will be required to complete BEFORE THEY BEGIN INTERNSHIP *
Check all that apply. Please check with your Human Resources Department if you're uncertain!
What time on Friday's during Internship will your Interns be required to report? *
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