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Texas Construction Career Academy

Registration Form

ALL INFORMATION PROVIDED ON THIS FORM WILL BE KEPT CONFIDENTIAL
1.
Demographics
Date
First Name
Last Name
Street Address
City
ST
Zip
Phone Number
Email
2.
Select Session
3.
Other Information
 YesNo
Are you 18 years or age or older?
Will you pass a drug test?
Are you physically able to perform road construction work?
If you were hired in a position, can you submit verification of your legal right to work in the United States?
Have you ever served in the military?
Do you have a current photo ID with a current address?
Are you able to pass a physical exam?
Are you willing to work outdoors?
Are you willing and able to attend classes for 2 weeks from 8:00 a.m. to 5:00 p.m. Monday – Friday?
4.
Educational History
5.
Skills Or Certifications
List any certifications (i.e. forklift, TABC, etc.):
List any special skills (i.e. computer, bilingual, etc.):
6.
Employment Experience
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
From
To
Reason for leaving
Responsibilities