1. (a) The employer’s establishment, proper school or post-secondary organization or rehabilitation facility’s representative shall apply to the commissioner for a sub-minimum wage rate for high school or post-secondary students or adults with disabilities working for practical experience prior to placement of any student or adults with disabilities with an employer’s establishment.

2. (b) The employers establishment, a proper school, post-secondary organization or rehabilitation facility’s representative applying for a sub-minimum rate or no rate for a high school or post-secondary school student shall provide the following on the "approval form for sub-minimum wage or no rate wage work based activities under RSA 279:22-aa":

   1. (1) Name and address of the school, post-secondary organization, or rehabilitation facility;
   2. (2) Whether the institution is secondary, post-secondary or other;
   3. (3) Indication of whether there is no rate wage, or a subminimum rate offered;

   4. (4) If the applicant is disabled, a selection of one of the following types of agencies providing the service:

      1. a. Vocational Rehabilitation (VR);
      2. b. Area Agency (AA); and
      3. c. Community Mental Health Center (CMHC).
   5. (5) The contact person, position title, telephone number, email address, and fax number;

   6. (6) Type of placement, whether:

      1. a. Job shadowing;
      2. b. Clinical;
      3. c. Work experience;
      4. d. Internship;
      5. e. Service learning;
      6. f. Mentor program;
      7. g. Situational assessment;
      8. h. Job training program; or
      9. i. Other.
   7. (7) The career interest or program name;
   8. (8) Description of the objectives;
   9. (9) Whether credit (direct or indirect) for graduation is given for this program;
   10. (10) The number of hours per day, days per week and total of days at each work site;
   11. (11) How the student will be supervised;
   12. (12) If applicable, a description of any hazardous equipment involved;
   13. (13) The authorized signature of the person at the institution or participating establishment and the position title; and
   14. (14) A statement that participating learning establishment work sites must be preapproved by the department of labor.

Source. #6996, eff 5-7-99, EXPIRED: 5-7-07 New. #8879, INTERIM, eff 5-18-07, EXPIRES: 11-14-07; ss by #9024, eff 11-9-07; ss by #11070, eff 4-11-16