Employer Interest Form

Company Name*

Primary Contact Name*

Contact Email*

Contact Phone*

Where would this job be located?*

Please be as specific as possible.

Is the workplace accessible by public transit?*

Position Type*

Application Deadline

Position Start Date

Position End Date

Age Requirements

Number of Positions Available*

Hours Per Week*

Shift Types

Other Shift Type(s)*

Job Description*

Primary Job Duties*

Is there a specific employment training program you'd like to hire youth from?

Which program(s)?*

Select all that apply.

Additional Details

Select all that apply.

Other Additional Details

Have you hired YouthCare youth before? If yes, please explain.

Email

This field is for validation purposes and should be left unchanged.