Rock Valley College
Rockford, Illinois

The Workforce Connection

Summer Youth Jobs Connection

Request for 2009 Summer Youth Work Experience Position

Position Request Business Information Form

Section I (Please skip to Section II if you have completed this form previously)

(If Applicable)

Public    
Not-for-Profit    
Private    
(Check the appropriate box)

(Area code + 7-digit number)

(Area code + 7-digit number)

(Required)

(Please complete all fields that are different from the contact info entered above)


Please enter your FIRST and LAST name


Yes    
No    


Yes    
No    


(If different from organization name above)

(If different from organization address above)


Yes    
No    


Select all that apply. To select more than one option, hold down control and click each option. Work permits for 14-15 year old youth will be obtained by The Workforce Connection.


(after May 1)


There must be at least one supervisor for every five summer youth workers. The Workforce Connection will perform criminal and DCFS background checks for all supervisors prior to youth beginning work. An alternative supervisor is required.


The work site agrees to instruct the summer youth worker in good workplace practices, to provide health and safety training as it relates to the specific job, and to motivate the participant to develop sound employment skills. Additionally, the workplace will provide training in the following specific areas:  (A job description may be submitted.)



Yes    
No    


The work experience person will be placed in an alternative job    
The work experience person will be released for the day    
Other    


Yes    
No    


Yes    
No    

(A background check will be performed for all summer youth ages 17 and older)


Yes    
No    



  mm/dd/yy
 
 

It is recommended that you print a copy of this form for your records before you click Submit.

This form is hosted on the Rock Valley College web site for our partners at The Workforce Connection. Any questions or problems should be directed to The Workforce Connection at (815) 395-6638.