Fillable Business/Internship-Vetting-and-Requirements-Form- Employers:!Please!save!this!form,!complete!the!information!as!best!you!can,!and!email!it!to!Matina! Wagner,!Internship!Coordinator!at:!mwagner@polk.e

Fill Online, Printable, Fillable, Blank Business/Internship-Vetting-and-Requirements-Form- Employers:!Please!save!this!form,!complete!the!information!as!best!you!can,!and!email!it!to!Matina! Wagner,!Internship!Coordinator!at:!mwagner@polk.e Form

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Business/Internship-Vetting-and-Requirements-Form- Employers:!Please!save!this!form,!complete!the!information!as!best!you!can,!and!email!it!to!Matina! Wagner,!Internship!Coordinator!at:!mwagner@polk.edu!for!assistance!in!establishing!an!internship.! (Polk State College)

On average this form takes 30 minutes to complete

The Business/Internship-Vetting-and-Requirements-Form- Employers:!Please!save!this!form,!complete!the!information!as!best!you!can,!and!email!it!to!Matina! Wagner,!Internship!Coordinator!at:!mwagner@polk.e form is 3 pages long and contains:

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Business/Internship-Vetting-and-Requirements-Form-
Employers:!Please!save!this!form,!complete!the!information!as!best!you!can,!and!email!it!to!Matina!
Wagner,!Internship!Coordinator!at:!mwagner@polk.edu!for!assistance!in!establishing!an!internship.!
Business:________________________________!!!!Contact:!______________________________!
Contact!info:!_____________________________!!!Title:!_________________________________!
Email:!___________________________________!!Website:!______________________________!
Address:!________________________________________________________________________!
Program!Target(s):!__________ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _! Degree!Target:
!
!AA!!!
!
!AS!!!
!
!BAS!
Concentration:!______________________________!!!! Opportunity:!!!!Inte rn ! !!
!!New!Hire!!
Internsh ip -C o mpens at io n!
Internships!must!comply!with!the!Department!Of!Labor!Fair!Labor!Standards!Act!criteria!for!paid/unpaid!
internsh ip s.!!See!www.polk.edu/interns,!www.dol.org!or!contact!the!internship!coo rdina tor!fo r!deta ils.!
Compliance!regarding!compen satio n:
"
!Y!!!
"
!N
If!no,!plea s e!e x p lain:!____________________________________________________________________!
Type-of-Business-–-please-check-those-tha t-app ly-for-th e-inte rns hip(s)-
!!
AgriQbusiness!
!!
Health!Care!
!!
Media!/!Publishing!
!!
Accounting!/!BookQkeeping!
!!
Hospitality!/!Tourism!
!!
Media!/!WebQbased!
!!
Education!
!!
Legal!/!Government!
!!
Media!/!Video/Film!Prod!
!!
Financial!/!Investment!
!!
Legal!/!Law!Enf.!/!Judicial!
!!
Network!Security/SystemsQIT!
!!
Industr ia l!/!Manufa c tu rin g!
!!
Logistics/Supply!Chain!Mgmt.!
!!
OnQline!bus in es s/ s erv ice s !
!!
Inform a tio n !T e ch n o lo g y!
!!
Marketing!/!Public!Relations!
!!
Product/Service!Sales!!
!!
Insuran c e!/ R isk !Mgmt.!
!!
Media!/!Advertising!
!!
Retail!/!Sales!
!!
Graphic!Arts!
!!
Media/!Public!Relations!
!!
Theater/Entertainment!
Other:!_______________________________________________________________________________!
Skill-Sets-Required-
Skill-
Proficiency-level-
MS!Office!Suite!(Outlook,!Word,!Excel)!
MS!Office!Access/Publisher/Project!
Customer!Service/Guest!Relations!
Oral!Communication/presentations!
Written!Communication!
Marketing!
Accounting!
Spreadsheet/Database!Skills!
Organization/efficiency/process!management!
Execution/project!management!
Creativity/problem!solving!
Initiative/ A cc o u n ta b ilit y!
Other:!
Technical-Skills-and-Certifications!(please!list)!
Required-
Preferred-
Work-environment,-conditions,-and-equipment-to-be-provided-for-intern:-
Assigned!supervisor!as!industry!expert:!"!Y!!! "!N!
If!no,!plea s e!e x p lain:____________________________________________________________________!
Dedicated!work!space:!"! Y!!!"!N!!!If !n o ,!p lea s e!e x p lain:!!_______________________________________!
Required!materials/tools/resources:!"!Y!!!"!N!!!If!n o ,!p le as e !ex p la in :!____________________________!
Safety!equipment:!"!Y! !!"!N!!!If!no,!p le a se !e xplain:!!__________________________________________!
Computer!equipment:!"!Y!!!"!N!!!If!no,!plea se !e xplain:!!_______________________________________!
Direct!phone/email:!"!Y!!!"!N!!!If!no,!ple a se !e x p lain :!!_________________________________________!
Specialized!equipment!training:!"!Y! !!"!N!!!Please!elaborate:!!__________________________________!
Specialized!business!training:!"!Y!!!"!N!!!Please!elaborate:!!____________________________________!
Polk State College does not discriminate on the basis of race, color, national origin, ethnicity, sex, age, religion, sexual orientation, marital
status, veteran status, genetic information, disability, or pregnancy in its programs, activities, or employment. The following person has been
designated to handle inquiries regarding the non-discrimination policies: Valparisa Baker, Director, Equity & Diversity (Title IX Coordinator) |
999 Avenue H NE | Winter Haven, FL 33881-4299 | Office: WAD 227 | 863.292.3602 Ext. 5378 | vbaker@polk.edu!
1- 2015/LC!
Environment(s):!!!!Indoors!!!!!Office/C ubicles!!!!!Outdoors!!!!!Industrial!!!!!Equipment/Machinery!
!!Variable!Temperatures!!!! !Noisy!!!!!Busy!Customer!Areas!!!
!!Other,!please!elaborate:!!____________________________________ _________ ___!
Physical!requirements:!!!!Walking!!!!!!Lifting !!!!!!Sitting!!!!!!Climbing !!!!!!Heat!!!!!!Cold!! !!!!Noise!!!
ADA!Compliant!facility:!"!Y!!!" !N!!!If!no ,!p lea s e!e x p lain:!!_______________________________________!
Other:!!_______________________________________________________________________________!
Selection/OnJboarding-requirements:-
Background!check:!"!Y!!!"!N!!!Please!elaborate:!_____________________________________________!
Drug/Substance!screening:!"!Y!!!"!N!!!!
Physical!Screening:!"!Y!!!"!N!!!!
PreQSelection!Assessment:!"!Y!!!"!N!!!Please!elaborate:!!_______________________________________!
Employee!Orientation:!"!Y!!!"!N!!!!
Job!Training:!"!Y!!!"!N!!!!
Description-of-duties,-projects,-and-responsibilities!(may!attach!a!job!or!position!description):!
Desired-schedule-including-number-of-hours-and/or-weeks-for-intern:-________________________ ___-
_____________________________________________________________________________________!
Is!sched u lin g !fle xib le ? !"!Y!!!"!N!!!!
Employer/Internship-Site-Reviewer:-_______________________________ _______-Date:-___________-
Comments:--__________________________________________________________________________--
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BusinessInternship-Vetting-and-Requirements-Form- Employers:Pleasesavethisform,completetheinformationasbestyoucan,andemailittoMatina Wagner,InternshipCoordinatorat:mwagner@polk.eduforassistanceinestablishinganinternship. (Polk

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Completed 10 October 2020

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