On-line Employment Request Form

Please provide us with your company and job information. Also, please note that we service youth of Evanston, Chicago, and surrounding suburbs.

Required fields are marked with *.

Company and Job Information:

Your Name *	Invalid Input
Your Telephone *	Invalid Input
Your Email *	Invalid Input
Your Title	Invalid Input
Company Name *	Invalid Input
Company Address *	Please enter the Company Address
Company City *	Please enter the Company City
Company State *	Invalid Input
Company Zip Code *	Please enter a valid 5-digit Company Zip Code
Company Telephone *	Please enter a valid Company Telephone Number
Company Fax Number	Invalid Input
Company Web site	Invalid Input
Business Type *	Please enter the type of business this is.
How did you hear about us? *	Please tell us how you heard about the Youth Job Center of Evanston
Job Title *	Please enter the job title.
Job Type *	Please enter the job type.
Job duties *	Please enter the duties of this job.
Job Skills Required *	Please enter the skills required for this job.
Days *	Please enter the days of the week the applicant is expected to work.(example: M-F)
Hours *	Please enter the hours expected to work. (Example: 9-5)
Hours Per Week *	Please enter the number of hours per week.
Hourly Wage *	Please enter the hourly wage this job pays (or approximate).
Number of Openings *	Please enter the number of openings you have to fill.
Benefits	MedicalDentalLifeOther
If Other, please explain:
How Should Candidates Apply? *	In PersonEmailFax How should a candidate apply for the position? Please check all that apply.
Dates/Time to Apply in Person	Invalid Input
Email Resume to	Invalid Input
Fax Resume to	Invalid Input
Notes to Employer Services Rep.	Invalid Input