Youth Worksite Program Application
The Town of Hempstead Department of Occupational Resources (DOOR) implements work experience programs for eligible youth who are Town of Hempstead/City of Long Beach residents, aged 16-20, and low-income. Youth are placed in various worksites within the area and serve as interns. Youth are paid $17 per hour by HempsteadWorks and can work up to 30 hours per week.
To be eligible, please ensure that your worksite meets the requirements listed here:
✓ Has business operations and jobsites located in Nassau County, Suffolk County and New York City
✓ Can provide a Federal Employer Identification Number (FEIN)
✓ Is in compliance with and agrees to follow all local, state, and federal labor laws
✓ Currently employed workers will not be fully or partially displaced by a Youth Intern
As a worksite for youth employment programs, each worksite will be responsible for the following:
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Assigning staff to supervise youth interns
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Providing youth with a brief orientation on their worksite duties, attendance policies, etc.
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Gathering youth’s timesheets and submitting them to DOOR on a biweekly basis
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Monitoring youth attendance, punctuality and job performance
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Creating a skills development plan for the youth intern and ensuring they meet the established goals throughout their placement.
To become a worksite for youth employment programs, please complete the worksite application below and provide a detailed job description(s) of the work in which youth interns will be engaged. Applications are reviewed on a rolling basis.
Please note that submission of an application does not guarantee that youth with be placed at your establishment.
To apply for a business training program, please complete the application below.
Instructions: Please complete all items on this application. To facilitate your review, please prepare this application electronically, if possible.
A. Company Information
1. Please indicate the number of youth you can place for this program
2. To what sector does your business belong?
2a. If the applicant is a School District, can you take on youth participants that are not currently enrolled in any of the applicant’s schools?
3. Is your business Minority/Women-owned Business Enterprise (MWBE)?
4. To which industry does your organization belong (select all that apply)?
B. Company Background
1. Has your company relocated from another area in the U.S. within the last 120 days?
If so, were there any employees laid off at that former location?
2. How long have you been in business in this area?
3. How many full-time employees do you have?
4. Are any employees on layoff currently?
5. Have any WARN notices been filed within the past year?
6. Is your business currently engaged in any labor disputes with a labor organization?
7. Will any currently employed individuals be displaced (even partial displacement such as reduction in hours) by the youth intern?
8 Are the facilities and equipment within the worksite where the youth intern will work safe (e.g., they do not present any obvious safety or health concerns)?
9. Is your company willing and able to provide the youth intern with the support they need to be successful at this worksite?
10. Is the worksite child-care related?
11. Will youth participants be instructed to work outside?
C. Job Position Information
1. Will the youth intern be required to participate in sectarian or political activities?
2. Would a youth's participation at your worksite provide opportunities for permanent employment and/or advancement within the company?
3. Will youth participants work on community service projects?
4. Will youth participants be instructed to handle dangerous tools (e.g. power tools or knives?)
5. Can your business hire individuals who are 16 and 17 years of age?
6. Please enter your availability for conducting youth interviews (days and times)
7. Will you require any additional forms (e.g., waivers, agreements, etc.) to be completed by interns before they start the program?
D. Job Description
Company Applicant Signature