JOB CANDIDATE INFORMATION FORM

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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)
Which program are you interested in? (Please select all that apply)
Job Readiness    
Correctional Transition Academy    
OnBoard4Jobs Program    
Heavy Equipment Training Program    
Veteran Training Course    
Other
How did you hear about the Statewide Workforce Development Program?
Job Fair    
OnBoard4Jobs.com    
Indeed.com    
Referred    
Social Media    
Billboard    
Sponsored Social Media Advertisement    
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: