New York Youth Jobs Program - Business Certification

IMPORTANT MESSAGE: Please be advised, we recently experienced an unexpected technical issue that resulted in a loss of data between the dates of March 25, 2024, and April 5, 2024. Any form(s) submitted during this time period will need to be resubmitted. We sincerely apologize for any inconvenience. Thank you.

* Indicates required fields

Questions? Need assistance? Call (877) 226-5724 or Email

Are you a PEO Member?

Yes

PEO Name:

PEO FEIN:

PEO Responsible Officer Name:

Business Name:

FEIN:

Industry Sector:

Business Address:

Business Address Line 1:

Business Address Line 2:

City:

State:

Zip:

Worksite Location:

Worksite Location same as Business Address

Worksite Location Address Line 1:

Worksite Location Address Line 2:

City:

State:

Zip:

My business is within a reasonable commuting distance of these target areas (Check all that apply)

City limits of:

Towns of:

Brookhaven

Hempstead

Additional Area

Recertifying for New York Youth Jobs Program

My business is new to the New York Youth Jobs Program

My business is already certified in the New York Youth Jobs Program or New York Youth Works

Contact Name:

Job Title:

Email:

Phone Number:

Extension:

Fax Number(Optional):

Are you a third party representative of the business?

Yes

Please provide the contact information of the third party representative of the business.

Business Representative Name:

E-mail:

Phone Number:

Extension:

Preferred Contact Method by Department of Labor:

Phone

E-mail

For efficiency purposes we will be communicating via email unless businesses request differently.

Terms of Service Agreement

I will list all New York Youth Jobs Program job openings for my company on the New York State Job Bank, to the maximum extent feasible. Job listing options include:
- Self-posting No cost service allows businesses to manage their job orders throughout the recruitment process. https://myjobsny.usnlx.com/
- Indexing No cost service to allow jobs posted on your company website to upload daily to the New York State Job Bank. https://jobs.usnlx.com/indexingrequest.asp?phase=3
I will confirm the hires of certified youth with the NYS Department of Labor.
New York Youth Jobs Program Confirm Hire Form
I agree to allow The NYS Department of Tax and Finance to share my wage records with the NYS Department of Labor.
The pay offered for this position is comparable to wages offered for similar jobs, with appropriate adjustments for experience and training.
My business has not intentionally reduced its existing workforce (i.e., terminated an existing employee or given an existing employee a partial work reduction) in order to hire a worker certified for the New York Youth Jobs Program.
I understand the reason a youth qualifies for this program is private personal information, and agree to not ask the youth to explain or describe the reason(s) they qualify for the program.
To the best of my knowledge, this information is true, correct and complete. I am aware that there are significant civil and criminal penalties for filing false documents or other information with the government.

By checking this box and submitting this form, I agree to the above Terms of Service Agreement.