Common Contracts
1 similar Work Experience Placement Agreement contracts
WORK EXPERIENCE PLACEMENT AGREEMENTWork Experience Placement Agreement • June 16th, 2016
PARTICIPANT’S NAME: AGE* : SOC. SEC. #: W-4 ATTACHED ❑ I-9 ATTACHED ❑ EMPLOYER: SUPERVISOR NAME: WORKSITE ADDRESS: PHONE #: PAY RATE/HR: TOTAL AMOUNT OF CONTRACT (# HOURS × PAY RATE/HR): * Worksite Supervisors are responsible for providing safe and healthy working conditions for participants, and for complying with the child labor requirements as describes in U.S. DOL Wage & Hour Division Publication No, 1330. When participants 14-15 years of age are assigned to a worksite, the Worksite Supervisor agrees to restrict their activities to those permitted in the above-references publication.
