UCLA Summer Youth Program

UCLA Summer Youth Program

2011

Date:

UCLA Departmental Work order request form

Campus Department:
Address: / Fax:
Supervisor: / Alternate Supervisor:
Phone: / Phone:
Email Address: / Email Address:

Job Duties

Number of students requested:______
Please check the skills the youth workers will acquire:
Clerical: oFiling oTyping oPhone oPhotocopying oFaxing oOther______
Computer: oData Entry oWord Processing oSpreadsheet oInternet/e-mail oOther______
Interpersonal: oClient Interaction oTeam Work oTime Management oOther______
Additional skills that a youth will learn:
1.  Will participant(s) work directly with clients (as child care aides, recreational aides, senior citizens aides, etc.)?
YES____ NO_____ If yes, what is the average daily number of clients? ______
2.  Participant’s work schedules will be standardized from 9:00 a.m. to 3:00 p.m. Monday through Friday.
Do you see any difficulty in structuring job assignments in this manner? YES______NO______
If yes, explain:
3.  Can your worksite accommodate youth(s) with disabilities? YES_____ NO_____
4.  What will be the ratio of supervisor to youth?
5.  Will participant(s) be transported in the performance of work? YES ______NO_____
If yes, explain why and describe the method of transportation:
Are there any special requirements for employment in your office such as fingerprinting or health check? If so, please explain.
Please forward this form as an attachment to Pamela Schachter by email ( ) or fax the form to the CBL office at X61455.