Internship Planning Thanks for reaching out! Please complete the information below. Entity name Department Contact person first name Contact person last name Email address Phone number Authorized signer of legal agreement name Authorized signer's email Are you a nonprofit or local government entity Nonprofit Local government entity Nonprofit type Church Medical Other Local government type County Municipality Special District Township Tribal Anticipated start date Anticipated end date How many hours per week Anticipated intern activities Nonprofit information What geographic areas does your organization serve within Sourcewell's region? Please check all that apply Cass County Crow Wing County Morrison County Todd County Wadena County Are you a 501(c)(3)? You may be required to provide an IRS determination letter Yes No What is your organization's mission? This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.