Revised: 10/26/2017
EMPLOYER REQUEST FOR A WORK-BASED LEARNING STUDENT
CONTACT INFORMATION
Email:
Company/Facility Name
Telephone:
Contact Person (First Name, Last Name)
Fax:
Title
Physical Address
City
State
Zip
Position Title:
Position Description:
Prefer Candidates Form:
(Please list curriculums)
Pay Rate:
# of Hours Per Week:
# of Job Openings:
Days Per Week Preferred:
Hours and Days of Operation:
Comments:
Please return to:
Antoinette Dickens, Point of Contact
Work-Based Learning Program
Vance-Granville Community College
P.O. Box 777/ 8100 N.C. 56 Highway
Louisburg, NC 27549
Email: dickensa@vgcc.edu
Phone: (252) 738-3609
Fax: (919) 496-6604
Date:
POSITION INFORMATION