Internship Sponsorship Form

	First Name, Last Name, and Preferred Title (Ms./Mrs./Mr./Dr./etc.):*

	Company/Organization Name:*

	Phone Number:*

	Email Address:*

	How would you like us to contact you?*
	How would you like us to contact you?* I would prefer to be contacted by phone I would prefer to be contacted by email I have no preference - both are fine

	What is the best time to reach you? If you would like us to contact you by phone, when would it be most convenient to call?
	8am - 10am    10am - 12pm    12pm - 1pm    1pm - 3pm    3pm - 5pm

	Please provide a brief description of your business and/or your position:

	What types of work-based learning experiences would your organization like to offer?* Check all that apply. Select at least 1.
	Internship(s)    Guest Speaker(s)    Career Fair Participation (Booth/Information Sessions)    Mock Interviews    Job Shadows    Mentorships    Industry Advisory Board Participation    Workplace Tours    Teacher Externship(s)    Project Consulting    Presentation Judging    Other, please specify

	For internships, how many interns would you like to host?
	For internships, how many interns would you like to host? One Two Three Four Five or more

	How did you hear about LAUSD Linked Learning?