ECRF-WVWW - West Virginia Women Work

WVWW Employment Confirmation Form

Student Name *

First

Last

Step Up Location *

Employer Name *

Name benefits? Step

Employer Address *

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone *

Job Title *

Starting Pay *

Is the pay? *

Starting Date: *

Hours per week? *

Does position offer medical benefits? *

Does position offer additional fringe beenfits such as paid time off, retirement/401k? *

Is this position considered non-traditonal? *

Did you get this position due to your Step Up Construction training? *

Will you be relocating for this position? *

Student Signature *

Clear Signature

Date *

Verification Method: