Participant Information Report – Supervisor Participation Report – Supervisor Report To be filled out by the Youth Supervisor when a Youth Intern is hired. Youth Supervisor Name* First Last Youth Supervisor’s PhoneYouth Supervisor’s Email Start Date* Date Format: YYYY dash MM dash DD Expected End Date* Date Format: YYYY dash MM dash DD Number of Hours per WeekHourly Rate*Declaration I hereby declare that no preference was given to the selection of an employee, who is a member of the immediate family of the employer, or an officer or director of the employer.
