* Name of Organization/Employer:
* Type of Organization:  
* Organization Industry Sector (NAICS):
* Worksite Address:  
* City:  
* State: * Zip Code:
* Telephone:
Fax Number:

* Name * Title: * Phone Number * Email
* Primary Contact:

* Alternate Contact:

If you have more than one work location, please complete a separate employer registration form for each location

* Do you have a Federal ID number?
* Has your organization participated in past CSSF Youth Work Programs?
* How many empoyees will your company hire?
Priority will be given for requests of 5 or more employees.

List occupations/jobs you have available:
Career interest in:
Positions available:
    (For this occupation)

     Starting Salary: ($)
Job Description:     (You must attach a document)

* The accepted file types are: txt, doc, docx, xls, xlsx, pdf, rtf
* Maximum file size is 10 megabytes (10,240 kb), larger files will be rejected.

CareerSource South Florida is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. All voice telephone numbers on this document may be reached by persons using TTY/TDD equipment via the Florida Relay Service at 711.