Experience may commence during this internship period(as a summer internship or work experience placement) and shall commence on or before June 30, 2019. This internship shall be undertaken at an organization that is eligible to receive Federal Financial assistance. If I do not know the name of the organization that I am interning in, is this an arrangement you wish me to consider? Yes No Would you allow this information to be released to the media? Yes No Any other information required by DOL? Yes No This information may be used to inform, evaluate and improve the administration of the Federal Work Opportunity Investment Act of 1996.
Note from DOL: The information received through this form is intended only to identify the intern or intern coordinator. It does not constitute an offer of employment by DOL, nor will it provide legal or other professional advice to the intern or intern coordinator. Please contact your local DOL office for more information, including specific questions.
If you have questions or need more information regarding this form, please email.
In rare instances where the organization is in violation of the Federal Law, a penalty assessment may come back into effect by requiring the organization to file an FP EID (Federally-Aided Internship/Work Experience Identification Number).
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DATE: Form must be submitted within 10 days of the date listed above IT Internship/Work Experience Commencement Form Your Information: Name: Address: Phone: Information about your internship site:
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