2023 Teacher Externship Program - Workplace Host Interest Form

Build the Workforce of Tomorrow, Today - 2023 Teacher Externship Program

Thank you for your interest in the hosting a Teacher Extern in your workplace this summer! Please complete the following information and our team will be in touch shortly to schedule a time to visit with you about the program. 
1.Company Name(Required.)
2.Who will be your company's primary Point of Contact regarding the Teacher Externship Program? (Required.)
3.Please provide a brief description of your company (or a link to the company webpage).(Required.)
4.How many teacher externs do you think your company would like to host? Please note, the cost to host is $3,500 per extern, which includes a stipend for the participating teacher. (Required.)
5.Externships are designed to last for two weeks, 32 hours per week.  Weeks can be concurrent or take place at different times during the designed time period. All externships must take place between June 5 and July 28. Please indicate below which weeks your company could host an extern. (Required.)
6.Externships are 32 hours each week, over four days. Which schedule would you prefer your externs work?(Required.)
7.All externships should take place between the hours of 7:30 a.m. and 5:30 p.m. Do you anticipate your company will be able to accommodate this daily schedule? (Required.)
8.Please detail any required safety equipment or safety precautions that your company requires.(Required.)
Company Provided
Required
Hard Hat
Steel Toe-Boots
Safety Googles
Masks
COVID-19 Vaccine
9.Expected dress attire for your extern(s)?(Required.)
10.Expected externship business environment?(Required.)
11.The Chamber will help you design your externship experience, however, what type of externship experience might fit within your organization?(Required.)
12.If you already know what type of externship you will offer, briefly describe it here. Example:  Externs will be able to shadow multiple positions and learn about various job responsibilities of our staff.  Day 1 will be spent working with the HR department. Day 2 will be working with our software program.  Day 3 will be spent shadowing our Production Manager.
13.Additional Information, Special Requests, or Preferences, if applicable (e.g., please note if you would prefer an Extern from a specific school district, etc.)
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