Externship / Job Shadowing Program

Externship / Job Shadowing Program Acknowledgment and Agreement Form

Externship / Job Shadowing Program Acknowledgment & Agreement Form
Externship / Job Shadowing Placements Available for High School (Age 16+) and College Students
These experiential learning opportunities are limited to one or two 4-hour days during an academic semester.
Extern's Name(Required)
First Last
Affiliated School / Organization(Required)
School / Organization Contact Name(Required)
First Last
Confirm School / Organization Contact Email(Required)

Current Or Intended College Major(Required)
College(s) Of Interest If Different From School Above(Required)
I and/or my parent/legal guardian (if applicable) attest that I understand that no monetary or equity compensation for this experiential learning experience will be provided by Goodwill Industries of Tenneva Area, Inc., and that I agree to abide by all policies and procedures of my educational institution for participation in Goodwill’s Externship/Job Shadowing Program. Furthermore, I and/or my parent/legal guardian (if applicable) attest that I will comply with all tenets of Goodwill’s Externship/Job Shadowing Program and with all applicable confidentiality regulations and policies both during and after my participation in the program.
Yes, I understand. (Required)
SELECT YOUR EXTERNSHIP OF INTEREST
Choose a career field(s) and select a work demonstration(s) within the field(s) from the list below:
BUSINESS
Accounting
E-Commerce
Entrepreneurship
Finance
Marketing & Communications
Retail Management
ECONOMIC DEVELOPMENT
ECONOMIC DEVELOPMENT
Facilities Management
Logistics & Transportation
Product & Supply Chain Management
Sustainability
EDUCATION
EDUCATION
Career Exploration
Digital Skills
Grant Administration
Instructional Design
Leadership
HUMAN RESOURCES
HUMAN RESOURCES
Employee Recruitment & Retention
Regulation & Compliance
Training & Development
HUMAN SERVICES
HUMAN SERVICES
Accessibility Services
Employment Support Services
Program Development
Veteran Services
INFORMATION TECHNOLOGY
INFORMATION TECHNOLOGY
Point of Sale Systems
Social Media
Systems Management
NON-PROFIT ADMINISTRATION
NON-PROFIT ADMINISTRATION
Project Management
Resource Development
Strategic Planning
Volunteer Management
REQUEST YOUR EXTERNSHIP SCHEDULE(Required)
Placements are limited to one or two 4-hour days during an academic semester.
Placements are limited to Monday through Friday. Weekend placements are not available. You will be contacted by your Extern Host to schedule the specific date(s), times, and location(s) of the externship and to discuss any areas of the career field on which you would like to concentrate. Please note that an externship may be limited to a 4-hour schedule only at the discretion of the Extern Host.
ARE YOU INTERESTED IN SCHEDULING A FREE CAREER NAVIGATION ASSESSMENT?(Required)
Yes
No
SELECT A METHOD OF CONTACT FOR AN INTRODUCTORY MEETING WITH YOUR EXTERN HOST(Required)
Phone
Microsoft Teams
Zoom
DEADLINE BY WHICH YOUR EXTERNSHIP NEEDS TO BE COMPLETED(Required)
MM slash DD slash YYYY

Eligibility: This statement certifies that I and/or my parent/legal guardian (if applicable) attest that I meet the eligibility requirements of this volunteer extern position. Individuals with current or adjudicated charges of assault/battery, child abuse, domestic abuse, murder, rape, sexual violence offense, or a charge with the aggravated designation due to violence or use of a weapon of any kind are not eligible for extern placement with Goodwill. Duration of this externship is limited to a maximum of eight (8) hours.

Age: This statement certifies that I and/or my parent/legal guardian (if applicable) attest that I am or will be 16 years of age or older on the day(s) of the externship. Proof of identity (driver’s license, school, work, or other form of valid ID) may be required upon check-in.

Conduct: This statement certifies that I and/or my parent/legal guardian (if applicable) attest that I will conduct myself in a professional and responsible manner while on any Goodwill-controlled property on the day(s) of the externship. No inappropriate conduct or language will be tolerated. Externs must follow the policies and procedures of Goodwill Industries of Tenneva Area, Inc. Externs exhibiting unprofessional behaviors and/or violating Goodwill policies, procedures, and/or the tenets of the Externship/Job Shadowing Program will be dismissed from the program by the Extern Host and will be asked to leave the premises.

Safety and Security: This statement certifies that I and/or my parent/legal guardian (if applicable) attest that I will follow all safety and security procedures and protocols as instructed by Goodwill staff on the day(s) of the externship. I understand that I and my family members are not allowed to shop at my assigned Goodwill retail location (if applicable) on the day(s) of the externship or to have items held for future purchase.
Emergency Contact Name(Required)
First Last
Emergency Contact Phone(Required)
Media Release: This statement certifies that I and/or my parent/legal guardian (if applicable) grant Goodwill Industries of Tenneva Area, Inc. the right and permission to take and use photographs, videos, and/or audio recordings of me related to my experience with Goodwill on the day(s) of the externship for news, publicity, social media, advertising, and other informational purposes. This statement certifies that Goodwill may use such images of me with or without my name and for any lawful purpose.

Liability Release: This statement certifies that I and/or my parent/legal guardian (if applicable) release Goodwill Industries of Tenneva Area, Inc. from any liability due to personal injury, illness, or damage to any personal property while completing this externship at any location of Goodwill Industries of Tenneva Area, Inc. to which I am assigned on the day(s) of the externship.

By typing a digital signature(s) below and clicking to submit this form, I and/or my parent/legal guardian (if applicable) certify that all information supplied in this online form is true and complete as well as acknowledge and agree to all terms and conditions of the Externship/Job Shadowing Program as set forth by Goodwill Industries of Tenneva Area, Inc. on the day(s) of the externship at the Goodwill location to which I am assigned.
Digital Signature of Extern(Required)
First Last
Age of Extern on the Day(s) of the Externship(Required)
Confirm Your Email(Required)

Confirm Your Phone Number(Required)
Digital Signature of Extern’s Parent or Legal Guardian
(Required if Extern is less than 18 years of age as of today’s date or subject to a legal guardianship).
First Last
Confirm Parent or Legal Guardian's Email

Are you the Extern’s parent or legal guardian?

Parent

Legal Guardian
Today’s Date(Required)
MM slash DD slash YYYY

Online Form Authorized 04/24

Externship / Job Shadowing Program Acknowledgment & Agreement Form

Externship / Job Shadowing Placements Available for High School (Age 16+) and College Students

These experiential learning opportunities are limited to one or two 4-hour days during an academic semester.

SELECT YOUR EXTERNSHIP OF INTEREST

Age: This statement certifies that I and/or my parent/legal guardian (if applicable) attest that I am or will be 16 years of age or older on the day(s) of the externship. Proof of identity (driver’s license, school, work, or other form of valid ID) may be required upon check-in.

Online Form Authorized 04/24