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Perry County Subsidized Employment Worksite Profile

Employer and worksite information
Employer Name:
Contact Person:
Address:
Phone:
Email:
Days/Times Per Week	Days per weekMTWTHFS a.m. to p.m.
Number of Employees Requested:
Will you accept 14 & 15 year olds?	Y or NMust be 16+ to operate weed trimmer

Job Title:

Brief description of job duties:

Dress code (Include preferred dress and prohibited dress):

Any required tools or supplies needed for youth to complete work (Please be specific of make and model(s), although we cannot guarantee the purchase of any/all tool requests):

Inclement Weather Provisions (If Applicable):

Who will be supervising youth? (Please list names/Phone #’s if different from above information)

Additional Information: