UPDATE: As of Dec. 5, 2022, MTIP is no longer accepting new application requests for Spring 2022 due to reaching our funding capacity for that semester. Application requests are being accepted for summer 2023 and beyond to support future intern recruitment efforts. Employers, please complete this application to be considered for funding from the Maryland Technology Internship Program. This form needs to be filled out for each individual intern position that you are applying for funds. Once submitted, you can also choose to create a copy of this internship for another candidate, or add a new internship position. Your contact information and employer details will carry over each time. (Note: This form works best in Chrome or Firefox browsers with JavaScript enabled.) Contact Information Your name*: First: Last: Title*: Primary phone number*: Email address*: (confirmation materials will be sent to this address) Payroll Is there someone who processes payroll who should be added to this application to fill out the reimbursement form? If yes, please provide their: First Name: Last Name: Email address: Employer Details Organization/company name*: This should be the full legal name of your organization and should match what is listed in your documents with the state of Maryland. Website*: Address 1*: Address 2: City*: State*: AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip code*: Short description of organization (Please provide a few sentences about your organization): Have you participated in MTIP before?* Yes No Industry*: -select one- AgribusinessEngineeringIT/Software Solutions & CybersecurityDigital MarketingManufacturing/LogisticsBiohealth & Life SciencesFinancial ServicesState and Local AgenciesNon ProfitOther Number of employees*: -select one- Less than 5050-99 employees100-149 employees150 or more employees Intern Fund Request Details Needs to be completed for EACH individual intern position that you are applying for funds. Semester/Term of Intern Hire*: -select one- Fall Spring Summer Year of Intern Hire*: -select one- 2023 2024 Internship Title*: Position Description*: Preferred Major(s)*: Funding Amount Requested* The Maryland Technology Internship Program can reimburse employers for up to 50% of an intern’s wages, and not more than $3,000 annually per intern (up to $1,800 for the first semester and $1,200 for a subsequent semester). Eligible employers are limited to a maximum of 6 awarded internships in a fiscal year (July 1 to June 30). An employer may apply for no more than two funding awards for the same candidate. Fifty percent of MTIP funding must be allocated to technology-based businesses with 150 or fewer employees. Hourly pay rate of intern*: $/hour Estimated total hours intern will work this semester (minimum 120 hours required)*: How will the internship benefit your organization?* How will the internship benefit your candidate?* Have you hired a candidate or made an offer?* Yes No If yes, indicate candidate's: First name: Last name: Email address: Would you like MTIP to advertise this position for you?* Yes No If yes, please provide an email address you would like applicants to send documents: Is this a new internship position for your organization?* Yes No If you have any other comments that you would like to add to your application, please enter them here: Application Confirmation* I certify that the above information is correct and that the funding I am applying for will be used to subsidize a candidate in a technical internship as defined by the Maryland Technology Internship Program. Yes