Opportunities in Construction Career Assessment

First Name

Last Name

Email

Phone Number

Secondary Phone Number

Home Address

City

State

ZIP

Birth Date

Race

- Select -Asian, Asian American, or Pacific IslanderBlack or African AmericanHispanic or LatinoNative AmericanWhite (non-Hispanic)Other

Gender

- Select -FemaleMale

Do you have reliable transportation NOW?

- Select -Yes

Can you provide proof of auto insurance coverage?

- Select -Yes

Do you have a high school diploma

- Select -Yes

Did you receive a diploma or a GED?

- Select -DiplomaGED

What year did you receive your HS diploma or GED?

High School graduated from/GED attained from:

List any construction education or training

Why are you interested in pursuing a career in construction?

What experiences have you had that have prepared you for a successful career in construction?

What career goals and interests do you have?

Describe your ideal construction career (type projects, your role/s (jobs) on projects, number of years you would work in construction, etc).

List any persons (name and phone number) that you know who are working in the construction industry.

List specific trade(s) you are interested in and provide a brief description of what you know about them

Can you work a ten hour, six day a week schedule in construction for 8-10 months out of a year?

Rate your fitness level on a scale of 1-10 (1 = poor, 5 = average, 10 = excellent)

If you attended Career Opportunities in Construction, which one did you attend? How did you learn about it?

Can you pass a Physical Fitness & Drug Screen Test?

Empty

Can you participate daily from 7:00am - 4:30pm?

Provide the name, email, and phone number of two professional or education references.

State

- None -

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