OJT Employer Form - OCIC | Ottawa County, Ohio

BUSINESS INFORMATION

EMPLOYER NAME *

FEIN # *

MAILING ADDRESS *

Address Line 1

Address Line 2

City

State

Zip Code

EMPLOYER REPRESENTATIVE NAME *

First

Last

EMPLOYER REPRESENTATIVE TITLE *

EMPLOYER REPRESENTATIVE EMAIL *

UNDER WHAT OTHER NAMES, IF ANY DO YOU DO BUSINESS? PLEASE LIST NAMES AND LOCATIONS BELOW *

HOW LONG HAVE YOU BEEN IN THIS AREA? *

LIST IN MONTHS/YEARS

IS THE BUSINESS BEING SOLD, CLOSED, RELOCATED OR MERGING WITH ANOTHER COMPANY? *

YES
NO

WHAT IS YOUR CHIEF PRODUCT OR SERVICE? *

LIST YOUR NAICS CODE: *

IF NOT KNOWN, SEARCH FOR NAICS CODES AT WWW.CENSUS.GOV/EOS/WWW/NAICS/

HOW MANY FULL-TIME EMPLOYEES DO YOU HAVE? *

HOW MANY PART-TIME EMPLOYEES DO YOU HAVE? *

HOW MANY NEW HIRES DO YOU ANTICIPATE MAKING IN THE NEXT TWO YEARS? *

WHAT JOB TITLES OR DESCRIPTIONS WILL NEED TO BE FILLED? (ATTACH JOB DESCRIPTIONS, IF AVAILABLE)

Click or drag a file to this area to upload.

DO YOU USE A STAFFING AGENCY? *

YES
NO

IF YES, 1) WHICH ONE(S)? AND 2) PLEASE DESCRIBE THE RELATIONSHIP: *

WHO WILL RECEIVE THE OJT PAYMENTS? (INCLUDE NAME, ADDRESS, AND CONTACT INFORMATION) *

ARE JOBS EXPECTED TO LAST A YEAR OR MORE IN THE NORMAL COURSE OF BUSINESS? *

YES
NO

DO YOU HAVE SUFFICIENT EQUIPMENT, MATERIALS, AND SUPERVISORY TIME AND EXPERTISE TO PROVIDE NECESSARY TRAINING? *

YES
NO

WHAT LICENSES OR ENTRY CERTIFICATIONS DO YOUR WORKERS NEED? *

IS THE PAY OF ANY JOB BASED UPON COMMISSIONS, TIPS, PIECEWORK, OR INCENTIVES? *

YES
NO

IS THERE A BASE WAGE THAT COMMISSIONS, TIPS, PIECEWORK, OR INCENTIVES ARE ADDED TO? *

YES
NO

IF YES TO EITHER OF THE TWO ABOVE, WHAT ENTRY EARNINGS MAY BE EXPECTED? *

WHAT FRINGE BENEFITS ARE PROVIDED TO REGULAR EMPLOYEES AND WHEN ARE THEY MADE AVAILABLE? *

DO YOU HAVE A PAYROLL SYSTEM THAT RECORDS ALL PAYCHECKS AND AMOUNTS? *

YES
NO

CAN YOU VERIFY WAGE PAYMENTS QUICKLY ONSITE? *

YES
NO

IF NO TO EITHER OF THE TWO ABOVE, HOW WILL WAGES BE VERIFIED FOR OJT PAYMENTS? *

WHAT IS YOUR WORKERS' COMPENSATION CARRIER (OR EQUIVALENT SYSTEM)? *

WILL OJT TRAINEES BE COVERED? *

YES
NO

ARE ANY OF THE JOBS CONSIDERED FOR AN OJT TO BE FILLED BY "INDEPENDENT CONTRACTORS" OR INDIVIDUALS NOT EMPLOYED BY YOUR FIRM DURING THE ENTIRE TRAINING PERIOD? *

YES
NO

ARE ANY OF THESE JOBS COVERED BY A COLLECTIVE BARGAINING AGREEMENT? *

YES
NO

IF YES, OBTAIN AND ATTACH A "CONCURRENCE LETTER" FROM THE UNION(S). *

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WHAT ARE YOUR TURNOVER PATTERNS AND CAUSES? *

COULD WE DO ANYTHING TO HELP LOWER YOUR TURNOVER? IF YES, PLEASE DESCRIBE: *

HOW MANY EMPLOYEES, IF ANY, ARE CURRENTLY ON LAYOFF, AND WHAT ARE THEIR JOB CLASSIFICATIONS? *

ARE THERE ANY OUTSTANDING WAGE AND HOUR; HEALTH AND SAFETY; OR DISCRIMINATION COMPLAINTS OR ADVERSE DECISIONS ON YOUR FIRM? *

YES
NO

IF YES, WITHIN HOW MANY YEARS? *

HAS YOUR COMPANY RELOCATED FROM ANOTHER LABOR MARKET IN THE U.S. WITHIN THE LAST 120 DAYS, LEAVING ANY WORKERS BEHIND? *

YES
NO

PLEASE LIST FACILITY LOCATIONS WHERE YOU ARE SEEKING OR RECEIVING WIOA OR TRADE ASSISTANCE FOR JOB LOSSES. *

PLEASE LIST FACILITY LOCATIONS WHERE YOU HAVE FILED 'WARN' NOTICES IN THE PAST SIX MONTHS. *

PLEASE PROVIDE THE DATE THAT PRODUCTION OF GOODS OR SERVICES BEGAN AT THE NEW LOCATION: *

OVER THE LAST TWO YEARS, WHAT PERCENTAGE OF PREVIOUS OJT TRAINEES HAVE COMPLETED TRAINING AND BEEN RETAINED BY YOUR FIRM? (ANSWER A-E)

A) NUMBER OF TRAINED EMPLOYEES RETAINED: *

B) NUMBER OF OJTs: *

C) DIVIDE LINE A BY LINE B: *

THIS IS THE PERCENTAGE OF PREVIOUS OJT TRAINEES

D) IF THE RETENTION RATE IS NOT ACCEPTABLE, WHAT IMPROVEMENTS ARE PLANNED? *

E) PLEASE EXPLAIN ANY EXCEPTIONS: *

I CERTIFY THAT THE ABOVE INFORMATION, TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT.

EMPLOYER REPRESENTATIVE SIGNATURE

DATE *

Once you submit..

You will receive a copy of OJT Employer Information form via the email your provided at the beginning of the form (please check your spam/junk mail).

After you hit submit, you will be redirected back to the OJT Section of the Training Assistance webpage. From there, complete the OJT Trainee Plan under Step 3.

Thank you.