MEDP Summer Internship Program Hiring Form

Thank you for hosting an intern for MEDP's Summer Internship Program. Please complete the following form confirming your hire. We encourage you to have made your hire and completed this form by May 1.

Company Name:
Internship Program (WORKS or Career Bound?) If hiring more than one intern please submit a second form:
Position Title:

First Name of Intern:
Last Name of Intern:
Intern's School:
Email for Intern:
Phone # for Intern:

Supervisor First Name:
Supervisor Last Name:
Supervisor Title:
Supervisor Email:
Supervisor Phone #:

Date of Hire:
Employment Start Date:
Employment End Date:
Rate of Pay (For Internal Reference Only):
Days Requested off:
Any special negotiations of employment (remote/hybrid, other?)?

Professional Development is offered to the intern cohort as a part of this program and is held weekly for 2-4hours, this is considered paid hours for the intern to participate. Interns and supervisors have found value in this offering through the skills and networking brought back to the place of business.

Would you be interested in offering to host a session at your location and/or present on a topic? If so please detail:

Thank you for supporting workforce development in our community!

Please select Submit to complete the form:

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231 NE 5th Street
McMinnville, OR 97128

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MEDP Summer Internship Program Hiring Form

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