Total KY residents
employed at
end of project (a+b):
9. Company's current total full time
Employees (including out-of-state):
10. How many KY residents will be trained
through this project:
11. Will trainees be paid while in training?
Yes
No
If No, you will have to fill out
a wage and hour
standards page.
12. Does a
collective bargaining unit
exist at the worksite where the
proposed training will be provided?
Yes
No
If Yes, further paperwork will need to be filed.
13. Has the company
been found
(adjudicated) to have commited a KY
OSHA violation?
Yes
No
14. Trainee Wages (List
trainees only)
Production
Number of Employees (a):
Average Wage:
Clerical
Number of Employees (b):
Average Wage:
Supervisory
Number of Employees (c):
Average Wage:
Technical/Maintenance
Number of Employees (d):
Average Wage:
Executive
Number of Employees (e):
Average Wage:
Total # of Trainees(a+b+c+d+e)
This total must
match number 10
Lowest Trainee Wage (Min. $8/hr.)
Minimum
$8/hour
Trainee Benefits
Percentage of Benefits
Vacation
Yes
No
Health Insurance Single
Yes
No
Dental Single
Yes
No
Retirement
Yes
No
Other
BSSC Flexible System Production Questions (5 points max)
Does your company participate in?
(Check all that apply to your company)
Active
Labor/Management Committee/ Program:
Yes
No
Actively participates in local, regional or state labor/management
activities/programs:
Yes
No
Active
safety & health committees/programs
Yes
No
Team
building
Yes
No
Employee involvement program
Yes
No
Industrial quality standard program
(if yes to this question,
additional information will be needed)
Yes
No
BSSC Progressive Company Initiatives (30 points max)
Is
this a consortia project?
Yes
No
Requesting BSSC funding for the first time in 10 years?
Yes
No
Expanding Company?
If so, what % of your total employee
count will be new jobs?
Yes
No
Career
Growth?
If so, trainee must receive pay increase
as a result of the project.
Please
include percent or dollar amount of
pay
increase & identification of class
title:
Yes
No
Services the needs of other KY companies?
Yes
No
If so, please provide examples:
Utilizes raw materials, products or services of KY vendors?
Yes
No
If so, please provide examples:
Participates in development of future workforce through activities
that prepare for work including, but not limited to: co-op,
work study, career days, job shadowing and school to work?
Yes
No
If so, please provide examples:
If you need to gather more information, just print the page, fill out the rest
manually and fax it to (859)266-3290, Attention: (Your Education Advisor)
