Please direct any questions about the reimbursement process to intern@masstech.org. The deadline for claiming reimbursement for the summer program is October 31, 2023. Company Information Company Name (DBA) This field is required. Legal Entity Name (if different from above) Mailing Address This field is required. Contact Name This field is required. Contact Email This field is required. Student Intern Information Intern #1 Intern #1 Student Intern #1 Name This field is required. Is Student Intern #1 being hired post-internship? Yes No If "Yes", will employee work Full-Time or Part-Time? Full-Time Part-Time Intern #2 Intern #2 Student Intern #2 Name Is Student Intern #2 being hired post-internship? Yes No If "Yes", will employee work Full-Time or Part-Time? Full-Time Part-Time Intern #3 Intern #3 Student Intern #3 Name Is Student Intern #3 being hired post-internship? Yes No If "Yes", will employee work Full-Time or Part-Time? Full-Time Part-Time Stipend Reimbursement Calculator Please enter your student intern pay data into this spreadsheet. Once completed save and upload the spreadsheet file below. Note: Hours worked should not include any paid holiday or vacation time. Upload Completed Calculator Spreadsheet This field is required. One file only.256 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Proof of Payment Proof of payment must verify: Intern name Company name Hourly wage or total hours worked Gross pay Pay period dates (check dates are not sufficient) Payroll tax deductions Acceptable proof of payment: Payroll reports, registers, or journals Paycheck stubs Earnings statements Unacceptable proof of payment: Canceled checks Any documentation that does not show required tax deductions Excel spreadsheets Payroll reports generated by third-party vendors are preferred. Do not send any documents that include Social Security Numbers. Proof of Payment PDF This field is required. One file only.256 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Tell us about your experience: What skillsets did your interns bring to the company and how are these helping the business? What sorts of projects did the interns work on/enable? What is the value to start-ups from a program like the MassTech Intern Partnership? How did you find, or otherwise match with your interns? Please certify the following: The above-mentioned intern(s) has/have performed the required duties of the internship(s) at the host company identified above. This field is required. The intern(s) has/have worked the hours indicated in the Reimbursement Calculator above. This field is required. The reimbursement requested hereunder is appropriate and in accordance with the terms set forth in that certain Intern Sponsorship Agreement between the above-mentioned company and the Massachusetts Technology Collaborative. This field is required. The above-mentioned company and intern(s) meet the MassTech Intern Partnership program eligibility requirements to the best of my knowledge. This field is required. By checking this box, I certify that I am a duly authorized representative of the above-mentioned company and that the statements made herein, including all attachments hereto, are true and correct to the best of my knowledge. This field is required. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank