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New York Youth Jobs Program - Confirmation of Hire

Governor Andrew M. Cuomo

Please Note: A 2017 confirmation of hire will only be accepted if it is submitted in 2017, not after.

Please have your printer ready to print the confirmation page that appears after you submit this form.

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If you have any questions you can contact us at (877) 226-5724 or E-mail

New York Youth Jobs Program Overview

SSN:*
- -
Hours per Week*
Phone Number*
( ) - ext.
E-mail*

Agreement

To the best of my knowledge, this information is true, correct and complete. I am aware that there are significant civil and criminal penalties for filing false documents or other information with the government.

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