Age Smart Employer Award Application: Small Businesses & Organizations

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1 Age Smart Employer Award Application: Small Businesses & Organizations For profits and Non profits with 5 to 99 employees. To win recognition as an Age Smart Employer with free publicity for your business please fill out the application below by May 10. It is easy to submit different methods are explained at the end of the application. Business/Organization Profile For use by businesses and nonprofits with 5 to 99 employees. If you have 100 or more employees, go to for Large Business application. Organization Name Address Website Social Media (Facebook, Twitter) What is your business/organization? (E.g. restaurant, preschool, etc.) Type of Business/Organization For Profit Nonprofit Other, please specify below How many people usually work at your business/ organization? (This includes both full time, part time employees and the owner(s)). If you hire temporary workers, please provide a separate number for them. Are there any employees who are over 50 years old (older workers)? Yes If yes, how many? No

2 Is the business owner or organization leader over 50 years old? (NOTE: Owners/leaders of ALL AGES welcome). Please briefly describe your business/organization s main activity or mission. How many years have you been in business? Please provide a brief history of your business/organization (when it started, major milestones etc.). Is your organization/business family owned? Yes No Contact Information Name Title or Role in Business/Organization Phone Number Address

3 Award Application Questions Staffing and Recruitment 1. What would you say is your biggest staffing problem or challenge? 2. What actions have you taken to address this challenge? 3. What do you do to find new workers?

4 Employee Performance 4. Describe ways you have made adjustments (changed work hours, reorganized responsibilities, paired workers together, etc.) to help workers or a specific worker continue to be productive as they age or their life changes. 5. Do you have older workers who are important to your business? 6. If yes, describe him/her (or them) briefly, explaining why they are valuable to you.

5 7. What strengths do you believe employees of different generations bring? 8. How do you use these strengths to help your organization succeed? 9. What do you do to make your business a good place to work? (this might include the general culture/tone, employee recognition, other)

6 Training 10. What kind of training do you provide to new employees? 11. How do you help workers and owners to keep up with changes in business/technology or learn new skills relevant to their jobs? 12. Describe how you pair workers together for training purposes? (E.g. job shadowing, mentoring, apprenticeships, cross training)

7 Strategies to Keep Valued Workers and Succession Planning 13. Please list any fringe benefits you offer to employees (health insurance, time off, paid time off, retirement savings, etc.) 14. What other actions do you take to keep workers who you value (especially older workers)? 15. What ways do you have for workers who have retired to stay involved? (E.g. volunteering, working occasionally, training new workers, etc.)

8 16. Do you have suggestions about information, programs, or regulation changes that would help you to find or make better use of older workers? 17. Have you made plans for a time when the current owners/leaders leave?

9 Additional Information How did you hear about the Age Smart Employer Award? If you could work with a consultant to help improve your organization, in what area would you be most interested in getting advice?

10 Age Smart Employer Awards: How to Apply ELIGIBILITY Any business and non profit organization with at least 5 employees located in New York City. There are two different applications, one for Large Employers and one for Small Employers. If your organization has under 100 employees please use the Small Employer Application. If your organization has 100 or more employees please use the Large Employer Application. You DO NOT need an answer for every question in the application in order to apply. Application Deadline: Sunday, May 10th, 2015 SUBMISSION INSTRUCTIONS: Choose the one that works for you 1. Apply Online Use our online applications at Save and submit by May 10 th, Send in By Download the appropriate application PDF from fill it out electronically, save a copy, then it to [email protected]. 3. Send in By Mail Download the appropriate application PDF from Fill out, print, and mail OR you can print out the blank document and handwrite your answers. Mail application to: Attn: Dana R Martens The New York Academy of Medicine, Room 441A 1216 Fifth Avenue New York, NY Concierge Service Let us help you! Our interviewers can help you fill out your application. We will come to you or arrange a phone call to assist you through the process. Then, we will arrange for you to review the completed application to be sure that the answers are correct/complete. Questions? [email protected] or call Dana Martens at The Age Smart Employer Awards is an initiative of the Robert N. Butler Columbia Aging Center and The New York Academy of Medicine, funded by the Alfred P. Sloan Foundation