PAYCheck Employers Interest Form

PAYCheck Employers Interest Form
Thank you for considering joining the PAYCheck program as an Employer Partner! This is the start of a vital community partnership to help young adults with disabilities gain independence through meaningful employment. As an Employer Partner, your organization distinguishes itself as an inclusive and diverse workplace.

PAYCheck is a Human Development Center program at LSU Health New Orleans. To learn more about HDC, visit https://www.hdc.lsuhsc.edu/.
Business Name*
City*
Your Name*

First NameLast Name
Your Job Title*
Type N/A if job title is unknown
Your E-mail Address*
example@example.com
Cell Number*
Please enter a valid phone number.
Employers can particpate in the PAYCheck program in 4 different ways:
- Worksite Visits: 2-5 participants come to learn about your business or organization and explore what positions are available. This is a 1-2 hour visit accompanied by a PAYCheck Coordinator.
- Job Shadowing: 1 participant shadows your employee(s) on a typical work shift. The participant is accompanied by a PAYCheck Transition Specialist and lasts about 4 hours.
- Paid Internship: Hire a participant to work 20-25 hours/week up to 10 weeks or 240 hours. All wages are reimbursed. A PAYCheck Transition Specialist will be available to job coach as needed. You may hire as many particpants as you'd like.
- Job Placement: Hire a participant as an employee to work part or full time!
How would you like to participate in PAY Check? Please select all the choices you're interested in.*

Worksite visitJob ShadowingPaid InternshipJob PlacementUnsure: would like more information about these opportunities
Other Comments
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