Business Inquiry Form for Participant Internship| Hempsteadworks

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Internship Worksite Interest Form

The Town of Hempstead Department of Occupational Resources pays the wages for interns who work at an organization to gain hands-on experience in their fields of interest. Internships may not exceed four months unless the total number of hours of the internship is less than 280 hours. Please complete the form below if you are interested in participating in an internship program.

Date:

1. To what sector does your business belong? *

Private / For Profit

Public / Government

Non-Profit

Large Non-Profit (i.e. universities or hospitals)

2. To which industry does your organization belong (select all that apply)? *

Construction

Manufacturing

Trade, Transportation and Utilities

Professional and Business Services

Health Care and Social Assistance

Leisure and Hospitality

Other

3. Has the establishment been the subject of a Federal, State, or City investigation, criminal, or civil action? *

Yes

4. Is the worksite child-care related? *

Yes

5. Will interns complete community service projects? *

Yes

6. Will interns be instructed to handle dangerous tools (e.g. power tools or knives)?? *

Yes

7. Please explain the type of activities in which interns will be engaged.

8. About how many interns can you accommodate at your organization?

Thank you. Your form has been submitted successfully.

An error occurred. Please make sure you submitted all the required fields. Thank you.

HempsteadWorks Career Center

50 Clinton St.

Suite 400

Hempstead, NY 11550

Accessibility

TEL: 516-485-5000

TTY: 1-800-662-1220

The Workforce Innovation and Opportunity Act financially assisted program is an equal opportunity employer / program. Auxiliary aids and services are available upon request to individuals with disabilities. To request reasonable accommodation, please call our Disability Resources Coordinator at (516) 485-5000 ext. 1113.

A service of the Town of Hempstead/City of Long Beach Workforce Development Board

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