Oregon | WORKS Participation Form

Oregon WORKS logo

Please fill out the following form to be considered as a Community Host for an Oregon | WORKS Community Internship Workshop. MEDP will be contacting the contact listed on the form within a week. If you would like more information about the Oregon | WORKS, please visit our webpage: www.mcminnvillebusiness.com/oregon-works

Participation forms must be filled out before April 21, 2017. Workshop dates need to be confirmed by May 5, 2017.

Organization:
Website: 
First Name: 
Last Name:
Title:
Address: 
Email:
Phone (123-123-1234):
Cell (123-123-1234):
 
Your Regional Solutions Coordinator: 
Email: 
Cell (123-123-1234):
 
Tell us about your community
Tell us about internship programs currently happening in your community:
Who would you like to invite to attend the Oregon | WORKS Community Internship Workshop?
What would be the desired outcome from a community internship workshop? 
 
Logistics
Event checklist (must answer yes to the following):
Can you fill a room with 20 stakeholders, business leaders, and others? 
Yes
No
Do you have a location for 20 attendees? 
Yes
No
Does the location have AV and WiFi? 
Yes
No
 
Scheduling
We are delivering a 6-hour training. Our agenda allows 30 minutes for a lunch break with two 10 minute breaks. Refreshments and meals are the responsibility of the host community. 
 
What are your preferred training dates between June 1-16? (prioritize three dates)
June 1
June 2
June 5
June 6
June 7
June 12
June 13
June 15
June 16
 
Prioritize your choices for one of four 30 minute pre-workshop planning sessions: 
May 8
May 9
May 15
May 17
Preferred Time 
Morning
Afternoon
 
Prioritize your choices for one of three 60-minute post-workshop coaching sessions:
June 19
June 20
June 26
Preferred Time
Morning
Afternoon
Any additional information you would like to provide us with?:
 
The Oregon | WORKS Workshop was developed by MEDP with the support of an Oregon Talent Council grant and in partnership with Governor Brown's Regional Solutions office. 
 
 
 

The Oregon | WORKS Workshop was developed by MEDP with the support of an Oregon Talent Council grant and in partnership with Governor Brown’s Regional Solutions office.




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