Worksite Request Form | Oneida County

Oneida County Workforce Development Summer Youth Employment Program 2022 Worksite Request Form.

If you have any questions about the Summer Youth Employment Program, please call David Mathis, Director of Workforce Development, at 315-798-5543.

( * ) indicates required field

Date

Agency

Address

Agency Contact

Phone

Job Title

# Youths Requested

Specific Job Duties

Minimum Age Requirement (and REASON)

Actual Worksite Location

Youth's Work Days & Hours

Immediate Supervisor

Supervisor's Title & Telephone #

Alternative Supervisor

Alternative's Title & Telephone #

Inclement Weather Plan (Include need for special uniforms, tools, and/or equipment & skills - i.e. typing)

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