Worksite/Employer Application : SGA Youth & Family Services

CONTACT INFORMATION

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Organization Name

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Worksite Supervisor Name

First Name *

Last Name *

Title

Phone

Organization Type

City Department
Other Government
Private
Non-Profit/Community-Based

Describe the organization's year-round function

Describe the orientation/on-boarding process

Is there a dress code? If yes, please describe

Do workers need to bring equipment/materials? If yes, please describe

JOB DESCRIPTION

Complete this section for each job title (one per page). If you need additional forms, please contact JLatorre@sga-youth.org and reference "Workforce Worksite/Employer Application Website Form."

Job Title

Number of Openings

Tentative Schedule: Sunday

Tentative Schedule: Monday

Tentative Schedule: Tuesday

Tentative Schedule: Wednesday

Tentative Schedule: Thursday

Tentative Schedule: Friday

Tentative Schedule: Saturday

Supervisor Name

Phone

Description of Duties

Key Competencies

Requirements (check all that apply)

Physical Exam
TB Test
Criminal Background Check

Is there anything else you would like to add about this position?

REQUESTING AUTHORITY

Must be initialed by agency director, board chairperson, management-level, or government designee.

Name

Title

Signature (please type initials)