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Job Shadowing Program
Host Employer Enrollment Form

The HempsteadWorks Job Shadowing Program offers youth participants the opportunity to explore career paths, gain hands-on experience, and observe the skills of professionals in their field of interest. Employers interested in participating in the program can register by completing the following form.

Contact Information
Business Information
Availability

Please provide details about your availability to host youth participants for job shadowing (up to 20 hours per participant).

Preferred Days for Job Shadowing (Check all that apply): 

Preferred Time of Day (Check all that apply): 

How many total hours can the job shadowing be (max is 20 hours per participant)? 

How many participants can you host?

Would you be willing to host multiple participants at once?

If yes, would you prefer to host the participants: 

Job Roles and Responsibilities

Please describe the tasks or roles the youth participants would observe or participate in during the job shadowing experience: 

Workplace Requirements

Please indicate if there are any specific requirements or restrictions for youth participants at your worksite:

Minimum Age Requirement:

Background check required:

Dress Code/Uniform Required:

Prior to hosting a job shadowing experience, I would like to arrange a casual meet-and-greet with the participant(s)

Host Employer Expectations and Agreements

By participating in this program, you acknowledge the following:

Please sign below indicating you have read the above information

Host Employer Representative

Thank you!  Your content has been submitted.

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HempsteadWorks Career Center

50 Clinton St.

Suite 400

Hempstead, NY 11550

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TEL: 516-485-5000

TTY: 1-800-662-1220

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The Workforce Innovation and Opportunity Act financially assisted program is an equal opportunity employer / program. Auxiliary aids and services are available upon request to individuals with disabilities. To request reasonable accommodation, please call our Disability Resources Coordinator at (516) 485-5000 ext. 1113.

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A service of the Town of Hempstead/City of Long Beach Workforce Development Board

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