2017 Subsidized Summer Youth Employment Program Application
NOLA Youth Works Summer Employment Program
3400 Tulane Ave., New Orleans, LA 70119
504-658-4531
Company Name
Your answer
Contact Person (Name/Title)
Your answer
Company Address
Your answer
Company Phone Number
Your answer
Company Fax Number
Your answer
Email Address
Your answer
Product/Service Provided
Your answer
Company Hours of Operation
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Company Summary
Provide a brief history of the company and a description of the type of products or services provided.
Your answer
Industry Type
Please check one industry that best describes your company
Required
Which program(s) are you interested in being an Employer for? (Check all that apply)
Please reference the program descriptions for more details on each program.
Required
Junior Camp Counselor: Below please indicate the number of positions available.
Please leave this blank if you do not want to be a Junior Camp Counselor Employer
Traditional: Below please indicate the number of positions available.
Please leave this blank if you do not want to be a Traditional Employer
Intern NOLA: Below please indicate the number of positions available.
Please leave this blank if you do not want to be an Intern NOLA Employer
Is this your company's first involvement with the Summer Youth Program?
What is your organization's legal structure?
Traditional: Below please indicate the available position(s), and a detailed description of duties.
(Detail Job description)
Your answer
Name and Title of person completing form.
Your answer
I, the undersigned, declare that I am an authorized representative of _________?
Fill in company name.
Your answer
I certify that all information submitted is true to the best of my knowledge. I understand that any false information submitted may result in the denial of my application for participation in the 2017 Subsidized Summer Employment Program.
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