Elevate- Employer Application

1
Tell us who is filling this form out; are you a business/employer interested in joining the Elevate program as a potential worksite or are you an LA County AJCC staff member?
I am a business/employer
I am an LA County AJCC Staff member
2
Tell us who is filling this form out; are you a business/employer interested in joining the Elevate program as a potential worksite or are you an LA County AJCC staff member?* This field is required.
I am a business/employer
I am an LA County AJCC Staff member
3
AJCC Assigned
Antelope Valley Comprehensive AJCC
East Los Angeles/West San Gabriel AJCC
Southeast Los Angeles Comprehensive AJCC
East San Gabriel Valley Comprehensive AJCC
Pomona Valley Comprehensive AJCC
Rio Hondo Comprehensive AJCC
South Los Angeles AJCC
Rancho Dominguez Comprehensive AJCC
4
Name of your business/worksite?* This field is required.
5
Worksite address.* This field is required.This is where Youth will work after being placed at your company.
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Business Contact Name.* This field is required.
7
Business Contact TitleExample: HR Manager, CEO, Owner, Operations Manager, etc.
8
Phone Number* This field is required.
9
Email* This field is required.
example@example.com
10
What size is your business?* This field is required.Based on number of employees
Small sized business 1-50 employees
Medium sized business 51-99 employees
Large sized business 100+ employees
11
How many employees work for your company?Enter a rough estimate of
12
Which sector is your business in?* This field is required.Choose the sector that most closely matches your business. If your sector is not on this list, choose "other" option and enter your sector manually, bonus points if you know your NAICS code :)
Healthcare (NAICS - 62)
Infrastructure (NAICS - 22)
Trade and Logistics (NAICS - 42)
E-commerce (NAICS - 45)
Transportation and Warehousing (NAICS - 48)
Advanced Manufacturing (NAICS - 31)
Entertainment and Creative Arts (NAICS - 71)
Information Technology (NAICS - 51)
Hospitality (NAICS - 72)
13
How many participants are you interested in hosting?* This field is required.Tell us how many Youth do you see yourself hosting and eventually hiring full time after program is over.
14
Youth@Work Elevate aims to connect Youth ages 17-24 to permanent employment after the program. Would your organization consider providing an offer of employment to qualifying participant upon completion of the program?* This field is required.We are giving preference to employers who are committed to hiring Elevate Job Seekers after program is over.
My business is committed to hiring participant(s) after satisfactory completion of the program.
My business is open to the possibility of hiring participant(s)
My business cannot commit to hire participant(s)
I need more information
15
Briefly describe the types of roles your organization may be able to offer to our Job Seekers* This field is required.This can be a role that you do not yet have but are looking to fill with a qualified candidate from this program
Ex: Office administration, Marketing, Sales, Human Resources, etc
16
Please describe any essential skills or considerations you are looking for in a job seeker* This field is required.This will help us identify the ideal candidate for this position
Example: Writing Skills, Communication Skills, Sales Skills, Business Operations Skills, Event Planning Skills, etc.
17
Please indicate if these positions are in-person, remote work, or hybrid* This field is required.
In-person only
Remote Telework only
Hybrid (Both in person and remote)
Not sure
18
How did you hear about the program?* This field is required.
Email Blast
Facebook
Instagram
LinkedIn
Twitter
Snapchat
TikTok
LA County DEO Website
Other LA County Website
On-line news site
Pinterest
Radio
Reddit
Referred by someone
Television
Tumblr
Unite-LA
WeChat
WhatsApp
19
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In Progress
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