Minnesota Department of Transportation Office of Civil Rights On-the-Job Training Program - Trainee Application MOVED FROM webteam.dot@state.mn.us

Office of Civil Rights On-the-Job Training Program

Trainee Application

The goal of the On-the-Job Training (OJT) Program is to create a diverse workforce through training people of color, women, and disadvantaged people in highway heavy construction. This program seeks to improve access for people to reach journey level positions.

You must submit an application for each trainee working on the project within 30 days of their scheduled start date. Submitted applications are subject to the approval of the OJT Program Coordinator.

Project Information

SP Number:*

Prime Contractor Information

Company Name:*

EEO Officer Name:*

EEO Officer Email:*

EEO Officer Phone:*

Does trainee work for a subcontractor? *

Yes No

Subcontractor Information

Company Name:*

EEO Officer Name:*

EEO Officer Email:*

EEO Officer Phone:*

Trainee Information

Name*

First Name

Initial (optional)

Last Name

Ethnicity:*

Gender:*

Last Four Digits of Trainee Social Security Number (SSN):*

Est. Start Date:*

Est. Number of Training Hours Assigned:*

Trade Classification*

Other:

Is the trainee part of a union?*

If trainee is enrolled in a U.S. Department of Labor and Industry (DOL) approved apprenticeship training program, please attach a copy of the Apprenticeship Agreement Certificate below.

No File Chosen

File uploads may not work on some mobile devices.

If the trainee is not part of a union, indicate how many hours the trainee has worked in an identified trade:*

Is the trainee a graduate from a MnDOT OJT Supportive Services Training Program?*

Yes No

From what MnDOT OJT Supportive Services Training Program did the trainee graduate from?

Graduation year:

If trainee completed a MnDOT OJT Supportive Services Training Program, will the trainee be assigned a mentor?

Yes No

Please complete an OJT mentorship agreement.

Equal Employment Opportunity Employer

Acknowledgement *

Enter email address

Note: Any information that you provide is considered public data under the Minnesota Government Data Practices Act, Minnesota Statutes, Chapter 13. This means that if someone, including the news media, requests this information we are obligated to provide it to them under the Minnesota Government Data Practices Act. See disclaimer.