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ADOT PRE-Apprenticeship for
Highway Construction Careers		  
Application  
Please answer all questions.
PERSONAL INFORMATION

Mr. Ms.    First Name:  Last Name:

 Address:   Apt #
 City:        Zip:
 Phone:      Email:    
EDUCATION (select highest completed)
Do you have a High School Diploma or  GED  Yes       No
GENERAL INFORMATION
 Why are you applying for this program?
 
 How did you hear about this program?
 Can you commit to attending this class for 6 weeks? (Monday through Friday, 8 a.m, to
  3 p.m.)     Yes       No
 If you are NOT selected for this session, do you wish to be considered for a later session?
Yes       No
 Please provide any other information that you feel would be helpful. 
 
EEO SELF IDENTIFICATION
The Arizona Department of Transportation is an equal opportunity affirmative action employer.  As such, ADOT is subject to US governmental recordkeeping and reporting requirements in accordance federal civil rights laws and regulations.  In order to comply with these laws, ADOT is required to collect data for statistical purposes about its workforce [anyone working for or at ADOT work sites]. Information will be kept confidential and will be used only for statistical purposes.  Your cooperation is vital and greatly appreciated.   
VETERANS STATUS
Are you a Veteran? Yes       No
ETHNICITY (Choose only ONE of the following, you can click on the ethnicity to see a description)
Hispanic/Latino   Not Hispanic/Latino
RACE (Choose only ONE of the following, you can click on the races to see a description)
White     
Black   

American Indian or Alaskan Native    
Asian
Native Hawaiian or Other Pacific Islander 
Two or more races
I do not wish to self-identify.  Choosing not to self-identify will NOT jeopardize or affect your status in any way. 
QUESTIONS?
If you have questions, please contact ADOT Civil Rights office at 602-712-7761.
By selecting "Submit Form" you are verifying that the statements made on this application are true and correct. The confirmation page you should see, after successfully submitting this form includes useful information about the training. Please take a few minutes to review.
 
  
 

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