Survey

Please provide the following contact information:

Name of Organization

First Name

Last Name

Address

City

State

Zip Code

Work Phone

Fax Number

E-mail

Type of Industry

Industry Types

Employment opportunities. Can you offer full time, part time, or seasonal?
(check all that apply)

Comments:

Is there an age constraint for employment, and if so what age?

If your establishment can provide internships are they student, teacher, or paid?
(check all that apply)

Comments:

Can you offer job shadow or tour site visits?
Yes    No

If yes, how many or how often?:

Can you donate Materials, Equipment, Money, or Personal Time to the schools in your community?
(check all that apply)

Comments:

Can you participate in job or career fairs?
(check all that apply)

Would you be a guest speaker and provide Industry specific information to students?
Yes    No

Would you like to work with the education system as a member of an advisory committee?
Yes    No

Any other ways you would like to work together with schools and students?

Would you like more information on providing any of these above-mentioned programs?
(check all that apply)

Other: