Yes, I Would Like To Participate In Hampden County's Annual Summer Jobs Campaign 2007!!!

Job Order Form

Step One: About the Company
Company Name: Date:
Address:
Telephone Number: Fax Number:
Contact Person: Title:
Email Address:
Size of Company: Number of Employees:
Goods & Services Your Company Produces:

Federal Tax ID #: ___________________________________________

(This information is required to post job order into the employment database at FutureWorks and/or CareerPoint)

Step Two: Tell Us About The Job

Job Description and/or attached company job description of worker’s duties/responsibilities below.
Job Position:
Hours: Full-time: (  )Yes Part-Time:(  ) Yes Shift:
Bus Accessible? ( ) Yes  ( ) No Minimum Age Requirement:

Benefits the Company Provides:
Number of  job Openings Salary Range?
Is the job temporary or permanent?
If temporary, what is the expected duration of the position?

Step Three: What are the Job Requirements
 Education Required:
Experience and Training:
Other:

Step Four: How to Apply
(Please check one) Applicant to apply by: (  )  Telephone  (  )  Mail in Resume  (  )  Fax  (  )  Walk-in  (  )  Email Resume
(Please check one) Would you like the job posting to be: (  )Private/confidential   (  )Open to the Public
(Please check one)  Post position (s) for: ( ) 30days ( ) 60days   ( ) 90days ( )120 days   ( ) Other

(Please check one) Are You interested in providing internships for local youth?  (  )Yes    (  ) No

Fax, mail or email form to:

Regional Employment Board of Hampden County, 1441 Main Street, Springfield, MA 01103

Attn: Kathryn Kirby, Youth Employment Coordinator

 Fax# (413) 755 - 1364 or Email Kirby@rebhc.org            

Simply fill out this form & fax it, we will refer to you youth interested in summer employment.  You are under no obligation to hire applicants referred under the Hampden County Summer Jobs 2007 Campaign.