JOB CANDIDATE INFORMATION FORM
Name:
Address:
City, State Zip:
Phone:
Email (if available):
Are you over the age of 18 and eligible to work in the United States?
Yes
No
Do you have a valid Florida Driver’s License?
Yes
No
Gender:
Male
Female
Please share your race and ethnicity so that FDOT can continue to receive funding from the Federal Highway Administration to provide this free service. Select all that apply:
Black/African American
Asian
Hispanic/Latino/Spanish
Middle Eastern
American Indian
Pacific Islander
White
Other
Primary language:
English
Spanish
Other
In which Florida counties are you willing to work? (Please select all that apply)
Alachua
Baker
Bay
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
Columbia
DeSoto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Glades
Gulf
Hamilton
Hardee
Hendry
Hernando
Highlands
Hillsborough
Holmes
Indian River
Jackson
Jefferson
Lafayette
Lake
Lee
Leon
Levy
Liberty
Madison
Manatee
Marion
Martin
Miami-Dade
Monroe
Nassau
Okaloosa
Okeechobee
Orange
Osceola
Palm Beach
Pasco
Pinellas
Polk
Putnam
St. Johns
St. Lucie
Santa Rosa
Sarasota
Seminole
Sumter
Suwannee
Taylor
Union
Volusia
Wakulla
Walton
Washington
Which program are you interested in? (Please select all that apply)
Job on Construction Project
Correctional Transition Academy
OnBoard4Jobs Program
Training Program
Fast Track Initiative
Other
How did you hear about the Statewide Workforce Development Program?
Job Fair
Other Event
OnBoard4Jobs.com
Website
Indeed.com
Referred
Social Media
Other
Education
High School (Name and City/State of School):
College (Name and City/State of School):
Other:
Skills and Qualifications
Skills, Licenses, Certificates, Trainings:
Previous Employment
Employer:
Project (if applicable):
Location:
Position Title:
Dates of employment:
From:
To:
Responsibilities:
Previous Employment
Employer:
Project (if applicable):
Location:
Position Title:
Dates of employment:
From:
To:
Responsibilities:
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