Employer Intake Form

Company Name * Required

Address * Required

County * Required

Dodge

Goodhue

Fillmore

Freeborn

Houston

Mower

Olmsted

Rice

Steele

Wabasha

Other

Website

Industry or Sector * Required

Agriculture, Food and Natural Resources

Architecture and Construction

Arts, Audio/video technology and Communications

Business, Management, and Administration

Education and Training

Finance

Government and Public Administration

Health Science

Hospitality and Tourism

Human Services

Information Technology

Law, Public Safety, Corrections and Security

Manufacturing

Marketing

Science Technology, Engineering, and Mathematics

Transportation, Distribution and Logistics

Number of Employees * Required

Point of Contact * Required

Job Title * Required

Email * Required

Phone * Required

Position(s) Title * Required

Department(s) * Required

Supervisor * Required

Basic Job Description: (Briefly describe the primary duties and responsibilities of this role. Be as descriptive as possible. Include a "day in the life.") * Required

Is this position * Required

Part-time

Full-time

Seasonal

Work Location

Compensation * Required

Paid

Unpaid

Stipend

WDI pays wages

If paid, hourly rate (Reminder that there may be opportunities for WDI to pay the wages or reimburse the wages for eligible participants):

Minimum age requirement? * Required

Does this position require safety training or protective equipment? * Required

Yes

No

Maybe

If yes "requires safety training or protective equipment," then please specify:

Will participants need to provide their own tools or uniforms? * Required

Yes

No

Maybe

If yes, "need to provide their own tools or uniform," then please list:

Why would a job seeker want to come work for you? (think of your culture and what will catch a job seeker's eye)

Preferred Soft Skills (Check all that apply) * Required

Adaptability

Communication

Conflict Resolution

Creativity

Critical Thinking

Customer Service

Digital Skills

Financial Literacy

Hands-on-Industry Experience

Leadership Development

Networking

Problem-Solving

Professionalism

Project Management

Public Speaking

Teamwork

Time Management

Work Ethic

Other

If other soft skills, which skills:

Preferred Technical Skills (Check all that apply) * Required

Computer Literacy

Data Entry

Hand Tools/Equipment

Cash Handling

Coding/Programming

Customer Relations

Other

If other technical skills, which skills:

Certifications Required (if any): (HS Diploma, Driver's license, OSHA, etc.) WDI might be able to assist with these, as needed, for eligible participants.

Preferred experience (if any):

Work Schedule * Required

Flexible schedule

Set schedule

Weekends required

Evening shifts available

Other

If other work schedule, please explain:

Days/Hours Available

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Shift(s) Available * Required

Hours per week: * Required

Seasonal Availability * Required

Year-Round

Summer Only

Other

If other seasonal availability, please explain:

Are there opportunities for career advancement? * Required

Yes

No

Maybe

If yes, describe the potential career progression within your company.

Do you offer additional training, certifications, or mentorship opportunities? Please list if so.

Would you consider hiring program participants for full-time roles after completion?

Yes

No

Maybe

What key skills will job seekers gain from this role? (Check all that apply) * Required

Adaptability

Communication

Conflict Resolution

Creativity

Critical Thinking

Customer Service

Digital Skills

Entrepreneurship

Financial Literacy

Hands-On-Industry Experience

Leadership Development

Networking

Problem-Solving

Professionalism

Project Management

Public Speaking

Teamwork

Time Management

Work Ethic

Other

If other key skills, which skills:

Will participants receive any of the following upon completion? * Required

Evaluation

Certificate

Letter of Recommendation

Other

If other, please explain:

Please provide any additional information that would help in matching job seekers with this opportunity or anything else you would like to add.

Ideally, when would you like this position filled by? What is your timeline?

How long do you want the job posting open for? If we are unable to find a suitable applicant, what is the best way to communicate back with you? * Required

If we have interested applicants for this opportunity, what are the next steps? (Online application, in-person, email a list of names/resumes): WDI will use this information to create a posting for this position. It will be shared with schools, community partners, and youth. We will connect interested youth with you in your preferred method. * Required

Electronic Signature - I confirm that the information provided above is accurate and that our company is committed to supporting workforce development through this opportunity. I give WDI permission to share this opportunity. * Required

Please sign electronically and date if you are in agreement. * Required

Are you interested in learning more about other Work-Based Learning opportunities? (apprenticeships, internships, on-the-job training, paid work experience, wage subsidy, youth skills training) * Required

Please list what you would like to learn more about it applicable: