MnDOT-DEED HHCT Program Year 2015

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1 MnDOT/DEED Highway Heavy Construction Training Partnership State Program Administration Minnesota WorkForce Center 540 North Fairview Avenue Suite 100 Saint Paul MN MnDOT-DEED HHCT Program Year 2015 Directions for completing the MnDOT-DEED HHCT Contact Data/Application Form 1. Read the Mn/DOT HHCT Program brochure and FAQ information sheets thoroughly. 2. Complete the Contact Data/Application form by carefully following the directions on each page of the form. 3. Submit the Contact Data/Application Form by doing the following: A. Remove this page and the FAQ section from the Application Form and either a. Fax all 3 sides of the completed Application Form to ; or b. Mail the completed Application Form to the address at top of this page. As an option, if you prefer to complete the application electronically you may to request an application. You will need to have Adobe Reader available on your computer to read and complete the application Please note the MnDOT-DEED HHCT Contact Data/Application Form may be used to identify how well you follow directions. Illegible or improperly completed forms may not be considered nor accepted. Only successful applicants will be notified and sent an interview scheduling letter by . If you wish to know the status of your application, contact the State Program Coordinator directly at Priority will be given to applicants who have successfully completed the National Career Readiness Certification (NCRC) exams, have achieved - at minimum - Silver level Certification and have included their NCRC scores on the HHCT application. All HHCT candidates will be required to complete the NCRC assessments before training classes begin. For more information about the National Career Readiness Certification program and to schedule your exams, please see your local Minnesota WorkForce Center! The MnDOT-DEED Highway Heavy Construction Training (HHCT) 2015 Partnership, funded by the MN Department of Transportation and managed by the MN Department of Employment and Economic Development, is designed to encourage the placement of underrepresented minorities and women in highway construction pre-apprentice laborer occupations associated with state/ federally funded highway construction projects. Graduates of the MnDOT-DEED HHCT Partnership Program receive basic training in construction terminology, safety rules and construction site safety (OSHA 30 certification), MnDOT flagger training, nutritional and physical preparedness/wellness and conditioning, use of hand and power tools, mathematics and associated measurements/dimensions/formulae in construction, highway construction industry norms and culture, and networking/job search/targeted resume development/job retention skills.

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3 MnDOT-DEED Highway Heavy Construction Training Partnership State Program Administration Minnesota WorkForce Center 540 North Fairview Avenue Suite 100 Saint Paul MN MnDOT-DEED HHCT Program Year 2015 Please read these FAQs (Frequently Asked Questions) about the MnDOT-DEED HHCT (Highway Heavy Construction Training) Program before you complete the Program Application Form! (Page 1 of 2) Am I applying for a job with MnDOT when I fill out the application form? No. The form is used to help us decide if you will be eligible for a specialized pre-apprentice laborer training program that may help you get an entry-level highway construction job with private construction companies. This is why we are asking certain questions, such as concerning gender, ethnicity and automobile ownership that you don t regularly find on an employment application. If your application is accepted, we will schedule you for a final screening interview to determine your eligibility for the training program. The Minnesota Department of Transportation (MnDOT) sponsors the MnDOT-DEED HHCT program; the Minnesota Department of Employment and Economic Development (DEED) coordinates and manages it. Am I guaranteed a job after the training is done? No. However, HHCT Program graduates will have gained highway construction industry knowledge, safety training and insights that will greatly improve their opportunities to get highway construction jobs. While in training, participants will be able to network directly with employers and local union officials and/or representatives. Program graduates are able to offer construction employers an HHCT Certificate, Minnesota Flagger Certification and OSHA-30 Certificate as evidence that they have completed the training program. How does the MnDOT-DEED HHCT Program compare to other construction training programs? 1. The HHCT Program is delivered state-wide and is authorized, certified and sponsored by MnDOT to strategically reduce the disparity in ethnic minority and female workers in Minnesota s highway construction workforce. 2. Program graduates receive several Certificates verifying their completion of the MnDOT certified HHCT training. 3. HHCT training is developed and delivered by thoroughly invested and proactive training vendors who have designed training curricula in strict conformance to MnDOT-DEED HHCT specifications and standards. OSHA certified instructors deliver OSHA 30 Certification training. Additionally, construction employers and union reps participate in delivering the training, thus providing great networking opportunities for HHCT graduates. 4. Program graduates receive case management, limited financial support and placement assistance through HHCT administration. Graduates are able to independently use the Minnesota WorkForce Centers vast resources for job search. Minnesota WorkForce Centers are strategically located throughout the state and offer access to regional career professionals who possess substantial experience with local employers and job markets. I have lots of practical construction experience. Do I still have to go through the HHCT training in order to receive Program benefits? Students must complete all training. You should note that applicants already possessing pre/apprentice/journey level construction experience/training or other similar training are not eligible for this program. Will I be paid while I attend the training? No. Do I have to pay for the training? No, it s free of charge. Can a person with a felony record apply for the Program? Yes. Highway construction occupations are among the most accommodating to ex-offenders. All participants must have unrestricted availability for all HHCT related events. The MnDOT-DEED Highway Heavy Construction Training (HHCT) 2015 Partnership, funded by the MN Department of Transportation and managed by the MN Department of Employment and Economic Development, is designed to encourage the placement of underrepresented minorities and women in highway construction pre-apprentice laborer occupations associated with state/federally funded highway construction projects. Graduates of the MnDOT-DEED HHCT Partnership Program receive basic training in construction terminology, safety rules and construction site safety (OSHA 30 certification), MnDOT flagger training, nutritional and physical preparedness/wellness and conditioning, use of hand and power tools, mathematics and associated measurements/dimensions/formulae in construction, highway construction industry norms and culture, and networking/job search/targeted resume development/job retention skills.

4 MnDOT-DEED Highway Heavy Construction Training Partnership State Program Administration Minnesota WorkForce Center 540 North Fairview Avenue Suite 100 Saint Paul MN MnDOT-DEED HHCT Program Year 2015 FAQs (Frequently Asked Questions) (Page 2 of 2) Can a non-female, non-minority person apply for the HHCT program? No person is restricted or prohibited from applying. Eligibility for the final screening interview will be determined by applying MnDOT-DEED HHCT program guidelines,...to reduce the disparity in ethnic minority and female workers in Minnesota s highway construction workforce. What happens after my application is reviewed? If your application qualifies, you will be scheduled for a final screening interview where you will be required to provide supporting documentation and answer several questions. If you pass the interview and if you do not currently possess a National Career Readiness Certification (NCRC) certificate, you will be advised to schedule for NCRC testing at a Minnesota WorkForce Center. NCRC testing verifies your math, reading and information locating abilities. Please note that applicants who currently possess and declare Silver NCRC Certification or higher on the HHCT application will be prioritized for interviews. You may also independently arrange for free NCRC testing at a Minnesota WorkForce Center. You will have one opportunity to complete the NCRC test and achieve a sufficient score; no retesting is permitted for the HHCT program. If your NCRC test scores are sufficient and completed in time, your MnDOT-DEED HHCT program training will then be scheduled at one of the HHCT District sites. If my HHCT Application is declined or my NCRC score is low or too late, what other opportunities are available? 1. It may be helpful to speak with a Minnesota WorkForce Center Representative to find information about alternative training and apprenticeship programs. Some training programs provided by schools and/or community agencies may require fees and/or tuition. 2. MinnesotaWorks.net offers powerful resources and information about job opportunities and current apprenticeships. 3. Additional trade apprenticeship information is available at Will I be notified if my HHCT Program Application is declined? No. Because of the tremendous number of HHCT applications we receive, we encourage applicants to to receive information about their HHCT application status. Only successful applicants will be sent an interview scheduling letter by . If I make a mistake on the HHCT Program Application and I m declined, can I fill out another application? If your current application is declined, we may consider your new application for the next HHCT Program Year. We advise declined applicants to carefully review all eligibility criteria detailed in the program brochure and these FAQ sheets. If I miss my scheduled HHCT interview, can I ask for another one? Because of the large number of HHCT program interviews we schedule we may, at our option, grant one (1) request for interview rescheduling. The candidate must have a substantial reason for missing the original/first interview and must call within 24 hours of the original/first interview time and date. Rescheduling will be at the sole discretion of the State Program Coordinator. Why do I need to declare vehicle ownership and insurance? Construction work requires independent transportation. Why do I need an account? Interview invitations and all program correspondences are distributed by . Where do I send the completed application? You may mail or fax it to the address/fax number at the top of this form. The MnDOT-DEED Highway Heavy Construction Training (HHCT) 2015 Partnership, funded by the MN Department of Transportation and managed by the MN Department of Employment and Economic Development, is designed to encourage the placement of underrepresented minorities and women in highway construction pre-apprentice laborer occupations associated with state/federally funded highway construction projects. Graduates of the MnDOT-DEED HHCT Partnership Program receive basic training in construction terminology, safety rules and construction site safety (OSHA 30 certification), MnDOT flagger training, nutritional and physical preparedness/wellness and conditioning, use of hand and power tools, mathematics and associated measurements/dimensions/formulae in construction, highway construction industry norms and culture, and networking/job search/targeted resume development/job retention skills.

5 MnDOT/DEED HIGHWAY HEAVY CONSTRUCTION TRAINING PROJECT CONTACT DATA AND APPLICATION FORM(BtB) Program Year 2015 This Contact Data/Application Form must be filled accurately, completely, and only by the Applicant. Failure to comply with the above directions shall result in the Applicant being dismissed from consideration. Effective 11/1/2014, only Contact Data and Application Form(BtB) Program Year 2015 will be applicable for the HHCT-2015 Program Year. MnDOT-DEED HHCT Administration reserves the right to reject any application. CONTACT DATA / GENERAL INFORMATION Name: Last, First, Middle Initial Address: Street Number, Apartment/Unit # years at this address: City, State and Zip Code) Phone Number: ( ) Cell Phone: ( ) (An active phone # or message phone # is necessary for HHCT program eligibility) Social Security # - - (An account is necessary for HHCT program eligibility) Do you possess the following? (A valid driver s license, an independently owned vehicle, and vehicle insurance are necessary for HHCT program eligibility) Driver s License? Yes or No If yes, check classification: Class A Class B Class C Class D Current Driver s License Number: State: Expiration Date: Do you own an automobile? Yes or No (A vehicle you that you own and vehicle insurance are necessary for HHCT program eligibility) Car Insurance Company/Agency Policy # Are you a US Citizen? Yes or No If not a US citizen, are you authorized to work in the U.S.? Alien Card # High School/GED Vocational Cert Associate Degree Four Year Degree Apprenticeship EDUCATION / TRAINING Yes or No School City/State Program/Major Dates Attended Graduated? Y/N (The National Career Readiness Certification exams are used to establish HHCT program eligibility and must be completed before starting HHCT classroom training. Preference will be given to applicants who submit copies of their NCRC exam scores/certificate with the MnDOT-DEED HHCT Application Form. All applicants must achieve at least level 4 scores in Reading, Math and Information Finding for HHCT program eligibility. See your District Workforce Center for more information.) Have you successfully completed the three-part National Career Readiness Certification exam? Yes or No If yes, write in your final scores and include a copy of your certificate: Reading Math Information Are you a Military Service Veteran? Yes or No If yes, do you have a service-related disability? Yes or No List all languages you speak: Occupational licenses, trade/technical and Apprentice/Journey certificates: What skills, knowledge, and training would you bring to a highway construction occupation? What construction or building equipment/machinery have you operated professionally?

6 MnDOT/DEED HIGHWAY HEAVY CONSTRUCTION TRAINING PROJECT CONTACT DATA AND APPLICATION PG 2 This Contact Data/Application Form must be filled accurately, completely, and only by the Applicant. Failure to comply with the above directions shall result in the Applicant being dismissed from consideration. EMPLOYMENT HISTORY Begin with your most recent paid or volunteer job and list all the jobs you ve had in the last 10 years. Blank/incomplete areas will not be accepted. All areas must be filled in accurately and completely. If you require additional space to list your work history, photocopy this page and include the additional pages with your application.. Most Recent Employer Date Started Date Ended Street Address City State Zip Job Title Hours per week Hourly wage Phone Brief description of duties and responsibilities DO NOT WRITE IN, SEE RESUME Why did you leave? Employer Date Started Date Ended Street Address City State Zip Job Title Hours per week Hourly wage Phone Brief description of duties and responsibilities DO NOT WRITE IN, SEE RESUME Why did you leave? Employer Date Started Date Ended Street Address City State Zip Job Title Hours per week Hourly wage Phone Brief description of duties and responsibilities DO NOT WRITE IN, SEE RESUME Why did you leave? HIGHWAY CONSTRUCTION EMPLOYMENT READINESS Highway construction jobs are physically strenuous and demanding, and often include exposure to temperature and weather extremes. You will likely be required to lift 70lbs or more occasionally, and 40lbs regularly. You will frequently bend, reach, climb, crawl, stretch, pull and carry large and heavy equipment and materials in limited access/confined areas. You will constantly listen/observe for hazardous machinery and traffic. You will monitor and assess potential and developing dangerous work environments/situations in elevated/subterranean/crowded/isolated work areas. You will monitor, respond to and/or report changes in machinery operating conditions. You will quickly and accurately receive, relay and implement verbal, radioed and written safety and work instructions. Will you be able to perform these required functions repeatedly, without distraction and under severe temperature/weather conditions without causing risk/endangerment to yourself or others? Yes or No Will you be able to work more than 40 hours/week, 8 hours/day and any shift without advance notification? Yes or No Do you have any current limitations imposed upon your Driver s License, other than prescription eyewear, that would restrict your 24-hour availability to drive to work anywhere in Minnesota? (A valid current driver s license is necessary to establish employment readiness and HHCT program eligibility, and to support your successful acquisition and retention of highway heavy construction jobs) Yes or No If yes, please identify the restrictions.

7 MnDOT/DEED HIGHWAY HEAVY CONSTRUCTION TRAINING PROJECT CONTACT DATA AND APPLICATION PG 3 This Contact Data/Application Form must be filled accurately, completely, and only by the Applicant. Failure to comply with the above directions shall result in the Applicant being dismissed from consideration. Why should we consider you for the MnDOT/DEED Highway Heavy Construction Training Program? Tell us why you would be a great candidate for this training program. Why should we invest time and $ in you? Argue your best case for yourself - be original and creative! Are you registered in and using the MinnesotaWorks.net program for job search? Yes or No If we were to interview your friends/work associates and ask them to describe you in only four words, what four words would they use? ELIGIBILITY/DATA STATEMENT AND APPLICANT SIGNATURE PLEASE NOTE THAT YOU ARE PROVIDING INFORMATION IN THE FOLLOWING SECTION THAT WILL BE USED TO DETERMINE YOUR MnDOT-DEED HHCT-2015 PROGRAM ELIGIBILITY. IF YOU CHOOSE NOT TO PROVIDE THE REQUESTED INFORMATION, WE WILL BE UNABLE TO DETERMINE YOUR ELIGIBILITY FOR THE MnDOT- DEED HHCT-2015 PROGRAM AND YOUR APPLICATION WILL BE DECLINED. NO NOTIFICATION OF DECLINATION WILL BE FORWARDED. THIS INFORMATION WILL REMAIN CONFIDENTIAL AND IS REQUESTED TO DETERMINE MnDOT-DEED HHCT PROGRAM ELIGIBILITY. Please check the appropriate boxes: Program Admin Office Use Only Gender: Female Male With which racial/ethnic group do you identify yourself? If the group appropriate for you is not listed, please check the one that comes closest. Please select only one group. Asian, Pacific Islander Native American or Alaskan Native White Hispanic/Latino Black/African American HHCT Program participants who receive some types of financial assistance or support may, on occasion, be eligible for additional financial incentives from the HHCT Program or program partners. Are you receiving funds or benefits from any of the following assistance/support or subsidization programs? FLAG LIC AG XO XO FAUX LIC ISSUE EMP FAUX NCRC PASS CAR NCRC SUB OTHER MFIP Section 8 Food Stamps Medical Assistance Dislocated Worker Social Security Disability Unemployment Insurance Other Compensation Program If you have any questions concerning the MnDOT/DEED HHCT-2015 Program or this application, please review the HHCT FAQ Sheet and tri-fold Brochure. You may also contact the MnDOT-DEED HHCT State Program Coordinator at or All applicants are advised that only eligible applicants will be notified and by only. Interview scheduling letters will be distributed by only. Missing or illegible applicant account information shall be cause for denying eligibility. ACCEPT DECLINE REASON DISTRICT FWRD DISTRICT ADMIN I certify that the information I provided on all pages and attachments to this Contact Data/Application Form is complete and accurate. I understand that I must contact the Program Coordinator directly for further information regarding my eligibility. I have read all parts of this application form and I understand that my giving false information or my failure to fully complete any section of this Form shall be cause for denying my eligibility for and/or subsequent participation in the MnDOT/DEED Highway Heavy Construction Training Program. I may request a photocopy of this completed application from the WorkForce Center. I understand that I am advised to read the MnDOT-DEED HHCT-2015 Program tri-fold Brochure and HHCT-2015 FAQ Sheet. I understand that I am limited to submitting one application for the MnDOT-DEED HHCT-2015 Program Year. I understand that additional screening and determination of HHCT Program eligibility will be performed and researched by the Minnesota WorkForce Centers and the MnDOT/DEED HHCT State Program Coordinator or designate before and after my interview. Applicant s Signature: Date: We are an Equal Opportunity Employer and Service Provider and are committed to recruitment, hiring, training and promotion of persons without regard to race, color, creed, religion, national origin, sex, marital status, status with regard to public assistance, disability, sexual orientation, veteran status or age. Access to and eligibility for some specialized programs and services, such as the MnDOT/DEED Highway Heavy Construction Training (HHCT) Program, may be limited to specific populations or demographics. This document is available in alternative formats upon request, including e-form. MnDOT/DEED HHCT Project Contact Information and Application Program Year 2015 REV 11/1/2014 csammann

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