Women Construction Driver Apprenticeship Readiness Training

ALASKA TEAMSTER-EMPLOYER SERVICE TRAINING TRUST 520 E. 34 th Avenue, Suite 201, Anchorage, AK 99503 Anchorage Contact: (907) 278-3674 Fax: (907) 279-6088 Fairbanks Contact: (907) 479-8451 Fax: (907) 456-6088 Statewide: (800) 478-4233 www.akteamsterstraining.com Women Construction Driver Apprenticeship Readiness Training Application Packet Cover Page Anchorage Training Session June 6 17, 2016 Application Deadline: May 6, 2016 Who Should Apply? Ladies, did you know that being a Construction Truck Driver is an excellent career for females? Do you enjoy working outdoors and want to feel proud of what you ve accomplished at the end of the day? Are you able to work long rotations in remote work environments? Are you interested in a Career with a union construction apprenticeship program? Will this career path provide a better life for you and your family? If so; we invite you to apply for this program for an opportunity to have all that and more. What is this Apprenticeship Readiness Training? It is a 2 week training program that will provide an opportunity to explore the basic construction truck driver (CDL) skills. You will receive classroom instruction to take DMV exams to obtain your CDL A permit, experience handson practice range time in a tractor-trailer, introduce you to the construction truck driver industry, and prepare you for entry into apprenticeship. More importantly at the successful completion of your training you will have a direct interview opportunity into the current Construction Truck Driver apprenticeship program. How Do I Apply? This is a unique opening and is a highly competitive opportunity. Only six (6) participants will be selected. Applicants must fill out the WCD Application and attach all required documents. It is your responsibility to include all information. Applications must be complete to be considered. Submit application packets in person or by mail to: Alaska Teamster Employer Service Training Trust Attn: Cheri Lipps, Apprenticeship Coordinator 520 E. 34 th Avenue, Suite 201 Anchorage, Alaska 99503 Eligible applicants will be interviewed for selection into the program. If selected for the program you will be required to obtain a DOT Medical Certificate and obtain and pass drug and alcohol screening prior to the start of the course. Instructions will be provide upon notification of acceptance. What Is the Cost? WCD training is free of charge to the applicant and is made possible from a State of Alaska STEP grant. Out of town Applicants: If accepted into this program you may qualify for financial assistance for travel and per diem expenses to attend this training in Anchorage. KEEP THIS PAGE FOR YOUR RECORDS 1 P a g e

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ALASKA TEAMSTER-EMPLOYER SERVICE TRAINING TRUST 520 E. 34 th Avenue, Suite 201, Anchorage, AK 99503 Anchorage Contact: (907) 278-3674 Fax: (907) 279-6088 Fairbanks Contact: (907) 479-8451 Fax: (907) 456-6088 Statewide: (800) 478-4233 www.akteamsterstraining.com Women Construction Driver - Apprenticeship Readiness CDL Exploratory Program Anchorage June 6 17, 2016 Application Number WCD0516: NO APPLICATION WILL BE PROCESSED AFTER 4:00 PM, May 6, 2016. Fill in all information, answer all questions and provide requested documentation. SOCIAL SECURITY NUMBER (Required): LAST APPLICANT NAME DATE OF BIRTH FIRST MI. MAILING ADDRESS CITY STATE ZIP RESIDENCE ADDRESS CITY STATE ZIP CONTACT NUMBERS CELL ( ) HOME ( ) MESSAGE ( ) E-MAIL PERMANENT FAMILY CONTACT INFORMATION: Someone who has a different phone number and knows how to contact you if you move LAST NAME FIRST NAME RELATIONSHIP TELEPHONE MAILING ADDRESS CITY STATE ZIP THIS SPONSOR IS COMMITTED TO EQUAL OPPORTUNITY FOR ALL APPLICANTS WITHOUT DISCRIMINATION BECAUSE OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, SEX OR AGE EXCEPT THE APPLICANT MUST BE AT LEAST 21 YEARS OF AGE. 3 P a g e Funding for WCD is provided by a grant from the Alaska Department of Labor & Workforce Development State Training and Employment Program (STEP) & ATESTT

To meet minimum qualification for program, applicants must: (Please initial each line) 1. Age: Applicants shall be at least 20 years of age upon submission of the application. They shall be at least 21 years of age by July 29, 2016. 2. Education: Shall possess sufficient educational knowledge to satisfactorily complete the related technical instruction. A high school diploma or GED equivalency is required. 3. Drivers License: Shall have a minimum class D ALASKA drivers license for at least one year prior to application and maintain that license and any other obtained in the program. 4. Clean Driving Record: Applicant must provide an Alaska Department of Motor Vehicle, Full Individual Driver Record, with application that indicates a clean driving history (Be certain to obtain the correct report from DMV. Approximate cost to applicant $10.). Any one of the following list of violations, from date of conviction on a driving record to date of application, will disqualify you as an applicant for the program. A total of 10 points on your driving record in the last two years. A total of three citations in the last three years. A citation for driving while using a wireless phone in the last three years. Two traffic citations, 10 mph over the posted speed limit in a three-year period. Any citation for 15 mph over the speed limit in a five-year period. A suspension or revocation within a five-year period. Any driving under-the-influence conviction within the last five years. Any leaving the scene of injury/property damage/accident, racing, reckless driving, failure to submit to a breath test, or using a vehicle to commit a felony within the last five years. 5. Physical: Shall be physically capable of performing the essential functions of the occupation, with or without reasonable accommodation, without endangering the health and safety of the individual or others. Shall pass and obtain a medical examiners certificate in accordance with the requirements of the U.S. Department of Transportation, USDOT (ONLY if selected into the program. Program will cover cost). 6. Drug & Alcohol: Shall obtain and pass drug and alcohol screening, includes UA test in accordance with the USDOT standards (ONLY if selected into the program. Program will cover cost and provide referral for testing). APPLICANT 1. What inspired your interest to be a Construction Truck Driver? Please explain. 2. Give a brief description of the kind of work you think is involved with this trade: 3. Besides pay and benefits; list some reasons why succeeding in the Teamster Construction Driver apprenticeship would benefit you personally. 4. Why should we select you for this program? Please explain. 4 P a g e

1. Do you foresee any problems with committing yourself to the program for the full two (2) weeks in Anchorage? Yes No 2. Are there any personal situations which may conflict with your training or employment? Yes No 2a) If yes, please explain: 3. Can you think of any restrictions on your ability to take jobs that require you to be out of town or to remote sites for a period of weeks/months? Yes No 3a) if yes, please explain: (Include any responsibilities that may preclude you from doing so.) 4. Do you have difficulty climbing on and off of vehicles or equipment? Yes No 4a) if yes, please explain: 5. Do you have reliable transportation? Yes No 6. Do you need assistance to attend training in Anchorage? Yes No 6a) If yes, you may need to apply for additional financial assistance if selected. 6b) If yes, what type of assistance do you think you will need? 7. Are you a high school graduate? Yes No 7a) If no, do you have a GED? Yes No 8. Did you ever participate in any kind of vocational technical training or school to work program during or after high school? Yes No 8a) Did you complete the program? Yes No 8b) Describe the program: 9. Have you ever been convicted of a felony? (Conviction may not automatically disqualify you.) Yes No 9a) If yes, explain giving details of arrest and the conviction (include year, the charge, the conviction, class of felony and sentence): 10. Do you have construction work experience? Yes No 10a) If yes, please give a brief description: 11. What other type(s) of training are you most interested in? 12. Do you understand that most construction work requires weeks/months at a time in remote locations. This means you may miss most holidays, family events and special occasions back home. Are you able to manage that? Yes No 13. Do you have a valid Alaska Driver s License? Yes No 13a) If yes, what class license (circle one): A B C D 5 P a g e

WORK HISTORY You must submit your Work History for the minimum past 5 years, indicating your present and previous employers. 1. Are you currently employed? Yes No 1a) If No, are you receiving UI Benefits? Yes No Exhausted Benefits 2. Do you have the legal right to work in the United States of America? Yes No EMPLOYER REFERENCES A resume may be included however this form is required to be completed. Begin with present job and work backward (including military service) 1. Job Position: Employer: Contact person: Phone: Dates of Employment: Hours/Week: Wage/Salary: FROM (mo/yr) TO (mo/yr) List the skills you used to perform on the job: Reason for Leaving: 2. Job Position: Employer: Contact person: Phone: Dates of Employment: Hours/Week: Wage/Salary: FROM (mo/yr) TO (mo/yr) List the skills you used to perform on the job: Reason for Leaving: 3. Job Position: Employer: Contact person: Phone: Dates of Employment: Hours/Week: Wage/Salary: FROM (mo/yr) TO (mo/yr) List the skills you used to perform on the job: Reason for Leaving: 6 P a g e

DOCUMENTATION I have checked the following boxes and attached the information. (These items must be included in full to process application.) Copy of my High School Diploma or GED (OFFICAL transcript acceptable) Readable photocopy of my Drivers License Copy of my Alaska Department of Motor Vehicles Full Individual Driver Record Copy of Social Security Card Proof of AK State Unemployment contribution within the past 5 years (can be a copy of a previous or current pay stub, W-2 or letter from unemployment office) Additional documentation Additional points will be given during interview if you include the following: WorkKeys / Career Ready 101. Provide a copy of Certificate or Score Sheets or verification from a Job Center that you are registered to take the WorkKeys or Career Ready 101 tests before May 25, 2016. Scores must be 4 (Silver) or higher. Two letters of support/reference for you to attend this training. 7 P a g e STATEMENTS OF UNDERSTANDING You Must Darken the Box for EACH of the Statements below to indicate your knowledge and understanding. Note: If you need clarification on any item DO NOT hesitate to ask. It is my responsibility to notify the program coordinator of any changes in my address or phone number. I have read, understand and meet all of the minimum qualifications specified in this application. To be eligible for the pool of candidates, I understand I must furnish all evidence and required documentation as requested. I understand that if I fail to submit ALL of the required information at the time application is submitted, my application will be considered incomplete. In the event I am selected for the program, any intentional or false statements or information that I have provided on this application form or other documentation shall be cause for denial of oral interview or termination of acceptance. I understand that if selected, I will be required to complete the selection process by qualifying on any examination, including a DOT physical examination and drug testing, either before or after acceptance to the program. I understand that only the original application form will be processed, and that photocopies are not acceptable. Applicant Certification: I have darkened all of the above statements to indicate my understanding, and state that, I authorize ATESTT to obtain personally identifiable information about my employment, education, and participation in programs from the state government, my employers, or other organizations when needed to carry out ATESTT program objectives. Understanding this need, I authorize these entities to release and/or verify such information to ATESTT at any time without my further consent. I certify to the best of my knowledge the information in this application is accurate, true, and verifiable. I understand that falsification of information to receive grant benefits may be grounds for removal from the program. I understand that there is a grievance procedure available that explains how I can appeal all eligibility decisions made with regard to this application for program services. I further agree to the use of my Social Security Number in order to determine my employment progress. Signature of Applicant Date Return this application by mail or in person to the Alaska Teamster Training Center, Apprenticeship Coordinator, 520 E. 34 th Avenue, Suite 201, Anchorage, Alaska 99503

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WCD Application Number WCD0516: Application EEOC Supplemental Information Form THIS APPRENTICESHIP SPONSOR IS COMMITTED TO EQUAL OPPORTUNITY FOR ALL APPLICANTS. THE RECRUITMENT, SELECTION, EMPLOYMENT AND TRAINING OF APPLICANTS DURING THEIR APPRENTICESHIP READINESS PROGRAM SHALL BE WITHOUT DISCRIMINATION BECAUSE OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, SEX OR AGE EXCEPT THE APPLICANT MUST BE AT LEAST 20 YEARS OF AGE TO APPLY AND 21 YEARS OF AGE AT THE TIME OF INDENTURE INTO AN APPRENTICESHIP. THE JATC DOES NOT, AND WILL NOT, DISCRIMINATE AGAINST A QUALIFIED INDIVIDUAL WITH A DISABILITY BECAUSE OF THE DISABILITY OF SUCH INDIVIDUAL. WE RESPECTFULLY REQUEST THAT YOU RETURN THIS FORM ALONG WITH YOUR COMPLETED APPLICATION FORM FOR WOMEN CONSTRUCTION DRIVER APPRENTICESHIP READINESS TRAINING. PLEASE COMPLETE THE FOLLOWING THE INFORMATION VOLUNTARILY PROVIDED BELOW IS SIMPLY FOR EQUAL EMPLOYMENT OPPORTUNITY COMMISSION (EEOC) PURPOSES. THIS INFORMATION WILL ASSIST US IN OUR EFFORTS TO PROVIDE ACCURATE INFORMATION IN COMPLIANCE WITH EEOC REGULATIONS AND REQUIREMENTS. Social Security Number: Date of Birth: Sex: Male Female Military/Veteran Status: Veteran Active Duty 9 P a g e Race: Darken only one & Ethnic Group: Darken only one American Indian Hispanic Origin Alaska Native Not of Hispanic Origin Asian or Pacific Islander Black White How did you become aware of this training opportunity? Alaska Works Partnership Helmets to Hardhats School Career Day Job Center Posting/ Counselor AATCA Website Earn and Learn website Guidance Counselor Posted Announcement (where) Other (please specify) Teamster Member (Name) (circle one: family / friend) This form will not become part of your personal file. It will be maintained in a separate file, only for EEOC reporting purposes.

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ALASKA TEAMSTER-EMPLOYER SERVICE TRAINING TRUST 520 E. 34 th Avenue, Suite 201, Anchorage, AK 99503 Anchorage Contact: (907) 278-3674 Fax: (907) 279-6088 Fairbanks Contact: (907) 479-8451 Fax: (907) 456-6088 Statewide: (800) 478-4233 www.akteamsterstraining.com DATE: March 1, 2016 TO: Division of Motor Vehicles - Driver Licensing Section FROM: Cheri Lipps, Apprenticeship Coordinator RE: DMV Service Request - Full Individual Driver Record (lifetime) The individual requesting this driver history is applying for apprenticeship to an Alaska Teamster Apprenticeship program. This program requires a full lifetime history record. We DO NOT accept 3 or 5 year records. Please assist this individual in obtaining the proper record. Thank you Cheri Lipps Apprenticeship Coordinator Take this Page to DMV to get accurate history report Keep this page for your records 11 P a g e