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Worksite Application for 2019 Summer Jobs Program

  1. YouthWORKS! 2019 Summer Jobs Program Worksite Application

  2. Worksite Point of Contact Information

    This is the point of contact for this agreement and site, who may or may not be the supervisor of the youth.

  3. Information Regarding the Position/Interviewee

    Please complete a separate agreement for each different position at the same worksite, if the supervisor, duties, and/or requirements are different.

  4. Each youth participant will be able to work between 15-20 hours, based on program funding.

  5. Please list other youth employee restrictions for your worksite (for example, age):

  6. Please describe the skills your worksite would like interviewees to possess:

  7. Would you hire last year's summer job employee?*

  8. Note: the youth must apply through our program's online application and meet our eligibility to participate in the program. He/she may visit for a link.

  9. The person who will have the most direct contact with the youth on the jobsite.

  10. Information Regarding the Schedule of the Positon

    Please complete information regarding the planned daily work schedule for this position, including a daily lunch break. Please remember that minors (age 14-17) may not work more than 5 hours without a lunch break of at least 30 minutes (per the Child Labor Law). Lunch breaks are unpaid.

  11. Youth can work a maximum of 20 hours per week each. If more than 20 hours are desired for this position you may consider two hires to fully cover the desired span of hours.

  12. Please list the anticipated schedule information for this position.

  13. Youth do not ordinarily work evenings or Friday - Saturday, but if you have this need, please describe and we will review the request.

  14. Please share any information or additional requests that you feel would help us in establishing a rewarding work experience for both you and the youth.

  15. Agreement of the Parties

    Please read the following agreement and certification.

  16. It is agreed that FCWS will: 1. Refer youth to worksite for interviews. 2. Assign a FCWS staff person who will serve as a liaison between worksites, youth and FCWS. 3. Orient employees and worksite supervisors to program activities, services, goals, policies, and performance standards. 4. Pay employees’ wages ($10.10 per hour) and provide Worker's Compensation coverage. 5. Resolve conflicts or violation of worksite policies in cooperation with the worksite supervisor and employee. 6. Provide youth with training and orientation prior to the hired youth reporting to your worksite on the first day of the program.

  17. It is further agreed that the aforementioned Worksite will: 1. Interview all referred applicants and select youth whose skills best match job description. 2. Provide structured, well-supervised work activities. 3. Assign quality, learning enriched tasks and ensure that they are consistent with the job description. 4. Provide adequate work to occupy fully the summer employee’s hours. 5. Ensure that all staff that you identify as immediate daily supervisors (i) receive a copy of this agreement; (ii) are available to discuss the agreement with FCWS staff; and (iii) participate in any planned worksite orientation and/or training. 6. Keep an open line of communication with the Frederick County Workforce Services (FCWS) staff and make FCWS staff aware of any performance issues before they become a problem. 7. Submit timely, accurate and signed timesheets and other reports as required. 8. Allow time for FCWS staff to visit with the worksite supervisor and summer employee to ensure that the Worksite Agreement is being implemented. 9. Ensure that youth do not work in buildings or surroundings under conditions that are unsanitary or hazardous to their health, and comply with applicable Child Labor Laws for youth under 18 years of age.

  18. Typing your name in the box above serves as the electronic signature of the representative of the Worksite authorized to enter into this agreement.

  19. Typing your name in the box above serves as the electronic signature of the individual who will serve as direct supervisor to the youth assigned to this Worksite.

  20. Kara Walker Fritz, FCWS Manager, Youth Programs and Talent Pipeline Development

    Kara Walker Fritz

  21. Phone


  22. Email Address

  23. Leave This Blank:

  24. This field is not part of the form submission.