Logistics & Production Worksite Application

Logistics and Production Worksite Application

Frederick County Workforce Services
Thank you for your interest in being a worksite for the Logistics and Production Program. Please provide the requested information about your position(s), and a member of our team will follow up with you. For more information about the Logistics and Production program, please visit www.frederickworks.com/logistics-and-productionemployers

Worksite Information
Name of Worksite*
(Name of Business or Organization)
Worksite Point of Contact Name*

First NameLast Name
Job Title*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Worksite Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Information Regarding the Worksite Position
Position Title*
Number of participants desired for this position*
Describe specific tasks for this position or upload a job description:
Please provide as much detail as possible
Upload the job description if available

Cancelof
Please list any policies that might apply to this position:
Examples: telephone/computer usage, attendance, breaks, lunch, smoking, etc.
Name of Immediate Supervisor*
The person who will have the most direct contact with the participant.
Direct Phone for Supervisor*
Please enter a valid phone number.
Email Address for Supervisor*
example@example.com

Position Schedule Details
Total Weekly Hours for Position*
Participants can work a maximum of 30 hours per week. A lunch break of 1/2 hour must be provided if working more than 5 hours a day. Lunches are unpaid.

Anticipated Schedule*

	Start Time	Lunch Break	End Time
Monday
Tuesday
Wednesday
Thursday
Friday

Other Schedule Information or Requests
Participants do not ordinarily work evenings (after 5pm), or weekends. If this is desired, please describe and we will review the request.
Additional Information or Requests:

Agreement of the Parties
It is agreed that FCWS will: 1. Refer candidates for interviews. 2. Assign an FCWS staff person who will liaise between worksites and participants. 3. Orient participants and worksite supervisors to program activities, services, goals, policies, and performance standards. 4. Pay participant wages ($17.00 per hour) and provide Worker's Compensation coverage. 5. Resolve conflicts or violations of worksite policies in cooperation with the worksite supervisor and participant. 6. Provide participants with training and orientation before reporting to your worksite on the first day of the program.

It is further agreed that the aforementioned Worksite will: 1. Interview all referred candidates and select participants whose skills best match the job description. 2. Provide structured, well-supervised work activities. 3. Assign quality, learning enriched tasks and ensure they are consistent with the job description. 4. Provide adequate work to occupy fully the participant's hours. 5. Ensure that all staff that you identify as immediate daily supervisors (i) receive a copy of this agreement; (ii) are available to discuss the agreement with FCWS staff; and (iii) participate in any planned worksite orientation and/or training. 6. Keep an open line of communication with the Frederick County Workforce Services (FCWS) staff and make FCWS staff aware of any performance issues before they become a problem. 7. Submit timely, accurate, signed timesheets and other reports as required. 8. Allow FCWS staff to visit with the worksite supervisor and participant to ensure that the Worksite Agreement is being implemented. 9. Ensure that participants do not work in buildings or surroundings under unsanitary or hazardous conditions to their health.
Worksite Representative Signature*

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Logistics and Production Worksite Application