2024 Summer Youth Employment Program

Request for Workers/Worksite Agreement


Site: ____________________________________________________


Number of Workers Requested: ____________        Work Hours: _______________


This document certifies a non-financial agreement between the City of West Haven, CT and ___________________, the Summer Youth Employment Program Worksite Sponsor. The dates of the program are July 8, 2024 to August 16, 2024 unless otherwise terminated.


The Summer Youth Employment Program Worksite agrees to do the following:

  1. Provide work experience training for participants, based on approved job descriptions.
  2. Provide a safe, healthy work environment for all participants.
  3. Follow all established time and attendance policies.
  4. Provide sufficient work, equipment, and materials.
  5. Ensure that participants do not engage in political, union, religious, or fundraising activities during work hours.
  6. Provide each participant with an orientation to worksite sponsor’s rules and regulations.
  7. Release participants for workshop, counseling, and related activities if applicable.
  8. Notify the Summer Youth Employment Program via westhavensyep@gmail.com of participant(s) actions which required corrective measures, counseling, discipline, or termination from the program.
  9. Ensure that youth are supervised at all times.
  10. Report work related injuries or illnesses to westhavensyep@gmail.com immediately.
  11. Comply with the Fair Labor Standards Act, applicable Child Labor Laws, CT DOL rules and regulations governing the Connecticut Youth Employment Program (CYEP).
  12. Make all worksite records and personnel available for monitoring by Federal, State, and Workforce Alliance monitors.
  13. Not hire any participants if the employer has terminated any regular employee or reduced the workforce with the intention of filling vacancies with participants whose wages are subsidized under this agreement.
  14. Ensure that no currently employed workers are displaced by any participants. This includes partial displacements such as reduction in work hours, wages, benefits, or overtime.
  15. Provide a work environment free from harassment or discrimination of any kind.



The Summer Youth Employment Program will:

  1. Provide orientation to worksite sponsors, supervisors, and participants. The orientation will consist of program goals, regulations, policies, procedures, etc.
  2. Provide payroll services and Workmen’s Compensation of Insurance for participants. Youth work experience program participants will be paid minimum wage for a work week of 20 hours.
  3. Initiate appropriate revisions to this agreement, if necessary.


For: Worksite Sponsor:

Signature: ________________________________________

Printed Name and Title: _______________________________________

Site Address:__________________________________________

Current and Preferred Contact Phone Number (to be used by staff and participants): __________________


For: Summer Youth Program

Signature: Jim Eagan

Jim Eagan

Program Coordinator