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Did you receive a Prevailing Wage Determination for this H-2B job order No Yes Employer Information: Employer/Business name: If applicable, Doing Business As (DBA): FEIN: Type of business: Business address: City: State: Zip code: Mailing address, if different: City: State: Zip code: Contact person: Title: E-Mail address: Phone: Fax: Job Order Information: Worksite, if different from business address: Daily travel to/from worksite provided: No Yes If yes, designated pickup location: Title of job opening: Number of openings: Education required: Experience required: Will you accept a trainee Will you accept related experience No Yes No Yes Will on-the-job training (OJT) be provided No Yes If yes, please specify: Job is full time, temporary and (check one): peak load seasonal one-time occurrence intermittent Dates: From To Work hours: From To Salary range: From Overtime offered Work days: To No Sun Yes Mon Housing description: Per If yes, at what rate Tues Pay day: Housing provided: Total hours per week: Wed Thurs Frequency of pay: No Yes Fri Varies Bi-weekly 1 Weekly Utilities paid by employer: Multiple occupancy house or apartment Sat No Yes Apartment or house for 1 worker Deduction for housing, if any: Other deductions (must comply with State and Federal Regulations): Other benefits provided: Driver’s License required: No Yes Class: Drug testing: No Yes 1Please note Section 191 of the New York State Labor Law requires manual workers be paid no later than seven calendar days after the end of the week in which wages were earned..
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