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Employer Application

Educators in Industry Employer Application
Please complete the below fields to submit your application. The Educators in Industry program for the Summer of 2017 will run from June 5 - June 30th.
* Application Date 
* Application Contact and Title 
* Application Contact Email 
* Company 
* Mailing Address 
* Physical Address 
* City 
* State (abr. - drop down) 
* Zip Code 
* Phone 
* Type of Business 
* If your company filed with the IRS as a charity or non-profit?
Company Website
* General background information about the company 
* How many positions are you applying for? 
* Educator in Industry Location(s) 
* Preferred Start Date 
* Preferred End Date 
* Briefly describe the tasks, responsibilities, and expectations you have of the Educator in Industry position(s). These may include, but are not limited to, special projects, routine work duties, staff relationships, travel, and equipment to be used. Your description should emphasize the educational experience that the educator will receive in exchange for their work. 
* Work Experience Supervisor 
How did you hear about the Educators in Industry program?
* Spam Check
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