Local Government Academy · 2025 Municipal Intern Program Placement Site Application

Placement Site Information

Municipality/Organization Name *

Email *

Verify Email *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Applicant Information

Name *

First Name

Last Name

Title *

Email *

Verify Email *

Phone *

Will the person completing this form serve as the intern's supervisor? *

Yes

No

Intern Project Supervisor

Name *

First Name

Last Name

Title *

Email *

Verify Email *

Phone *

Is your municipality accessible by public transportation? *

Yes

No

If yes, please provide details such as bus line, stop information *

Has your municipality participated in our internship program in the past? *

Yes

No

If yes, please specify the year(s) and the location *

If you are not matched with an intern, do you plan to hire an intern anyway? *

Yes

No

Project Overview

Project Title *

Project Description *

(60 words or less)

Please give a detailed description of anticipated intern assignments *

(120 words or less)

Explain why your project should be selected *

(60 words or less)

Explain why an Intern would want to work with your Placement Site. *

(60 words or less)

What are the anticipated benefits to the placement site and/or community? (Check all that apply) *

Increase efficiencies through database development/enhancement

Promote walkability and pedestrian access

Document blight and abandoned buildings

Enhance understanding of local needs and desires through community organizing and engagement

Improve traffic circulation and road safety

Build staff capacity to improve infrastructure asset management

Other benefit

Other Benefit (please specify) *

60 words or less

Is the proposed project part of a larger municipal initiative? *

Yes

No

If yes, explain how *

(60 words or less)

What functional area/department(s) would the proposed project involve? (Select all that apply) *

Administration

Data/Technology

Finance

Parks & Recreation

Personnel/Human Resources

Planning/Community Development

Other

Other area/department(s) *

Evaluation Criteria

To qualify for this program, the supervisor &/or other representative is required to attend one or more events. Do you certify that the Placement Site will meet this requirement? *

Yes

No

To qualify for this program, the Placement Site is required to ensure that the Intern can avail themselves to the in-person activities, which may include providing transportation to one or more events. Will the Placement Site be able to ensure this? *

Yes

No

How frequently will the supervisor meet with the intern to review their progress? *

Daily

Weekly

Bi-weekly

Monthly

Other

If other, please specify *

Will the intern have a dedicated workspace at the Placement Site? *

Yes

No

If no, how will you accommodate the intern’s work needs? *

Will the Placement Site provide a computer and/or other technology to support completion of work assignments? *

Yes

No

If no, how will you accommodate the intern’s work needs? *

How often will the intern have opportunities to meet or collaborate with other departments within your municipality? *

Regularly (Multiple times per week)

Occasionally (Once per week)

Rarely (Once per month)

Never

Other

If other, please specify *

What, if any, key experiences or special opportunities will you offer the Intern to learn more about local government? *

Attend Public Meetings

Facilitate stakeholder meetings

Engage with the public at community events

Attend meetings with Co-workers at the Placement Site

Attend meetings with companies conducting business with the Placement Site

Job shadow departments

Other

If there are other key experiences or special opportunities, please specify *

Will the intern have the opportunity to make a presentation to elected officials &/or the community? *

Yes

No

If yes, describe the nature of the presentation(s), and how you will ensure the intern is prepared for the presentation. *

(60 words or less)

For what reason(s) are you interested in submitting an application for this program? *

To make it financially feasible to host an intern

LGA helps facilitate a student match for our project

The program brings us a wider pool of candidates than we might normally attract

Other

If other reason, please specify *