Employer Application and Outreach Form
How did you hear about the office of Work-based Learning? *
Email
Talent & Industry Partnership Coordinator, Work-Based Learning
Had an intern before
Presentation
Referral from another Sinclair department
Website
Student
Other
Employer Confirmation:
I'm looking for an intern.
I've already selected a Sinclair student for this internship.
A current employee will use their position as their internship.
A Sinclair student has already completed their internship, and I'm submitting this on their behalf.
How did you hear about us?
Other, please specify: *
Contact Information
Date *
Company Name *
Address *
City *
County *
Montgomery
Allen
Auglaize
Butler
Champaign
Clark
Clermont
Darke
Delaware
Fayette
Greene
Hamilton
Logan
Mercer
Miami
Preble
Shelby
Union
Warren
Wayne
Other
State *
ZIP *
How do you prefer to be contacted? *
Phone call
Email
Text
N/A
Company Website *
Company Phone *
Company Fax
Contact Name *
Contact Email *
Contact Phone *
Contact Job Title
Contact Department
I'd like information on the following WBL services *
Internships
State Registered Apprenticeships
Pre-apprenticeship
Job Shadowing
Not Applicable
Employer Type *
For Profit
Non-Profit
Non-profit EIN
If non-proft, what is the EIN?
Submit
