Juneau Construction Academy Application FY 21

Juneau Construction Academy Application

Status

Selected Confirmed Completed Did Not Complete No Show

Other:

Photo ID

Yes No

Other:

Test Scores Information

Submitted Career Ready 101 scores Submitted Work Keys Scores Military Exempt

Other:

Drug Test

Registered Successfully Completed Military Exempt

Notes regarding applicant

Name*

First Name

Last Name

Cell Phone*

Emergency Phone Contact Name and # *

e-mail address*

Verify e-mail address *

Age Range:*

Date of Birth*

Gender*

M F

Physical Address *

Address Line 1

Address Line 2

City

State

ZIP Code

Mailing address (if different from physical address)

Address Line 1

Address Line 2

City

State

ZIP Code

Do you have a High School Diploma or GED?*

Yes No

Do you have a valid ALASKA Drivers license?*

Yes No

If no AK driver's license, do you have a valid Driver's license in another state?

Yes No

Drivers License or Photo ID #*

Race*

Hispanic/Latino Caucasian Asian African American American Indian Alaska Native Hawaiian/Pacific Islander

I am currently or have served in the U.S. Military.*

Yes No

Have you lived in Alaska for thirty days or more?*

Yes No

Do you intend to stay in Alaska and make it your home?*

Yes No

Citizen Status*

United States Citizen Permanent Resident Alien Refugee or Parolee Temporary Work Permit Other

Do you risk losing your job due to a downturn in the economy?*

Yes No

Pre program hourly wage (Hourly wage at your current or most recent job)*

What is or was your Pre-Program Occupation / Title (position at your current or most recent job)*

Employment: You are currently:*

Employed Not Employed Underemployed

Are you able to perform the essential functions of this training program with or without reasonable accommodations?*

Yes No

Have you completed any trainings through any of the Alaska Construction Academies?*

Yes No

1.) Do you have any construction experience? If not, explain why you are interested in Construction training. (Experience not required for our classes)*

2.) Will you be able to attend each day of the selected training on time?*

Yes No

3.) Do you have reliable transportation to attend training?*

Yes No

4.) Do you plan on applying for a construction job or a trade apprenticeship program?*

Yes No

7.) Briefly describe your career goals.*

8.)Why do you think we should choose you for this training opportunity?*

10.)Do you have any additional questions or comments about the program, any information you want us to know about you, etc.?

Applicant Certification
As a non-profit program providing services through State grant funds, there are required documents and information for you to review and verify that you agree to abide by their policies.
PLEASE REVIEW THE LINKS BELOW TO COMPLETE YOUR ONLINE APPLICATION.
If you disagree with any of the policies, we are unfortunately unable to consider you for training.

Equal Opportunity Program: To Review Equal Opportunity Law CLICK HERE

I hereby certify that I have read and understand the content of the Equal Opportunity Law Notice*

Yes

Media Release: For and in consideration of the opportunity and privilege of appearing in or participating in one or more videos, sound tracks, films, photographs, written articles, brochures, training manuals, or recordings, I hereby consent to the use and editing thereof and release SERRC, this training provider, the Department Of Labor & Workforce Development, and its employees as assignees from any and all claims resulting from such use, sale, editing, and release to media, newsletters or training manuals.*

Yes

After submitting your application, you will receive an automatic confirmation email with important additional information. Please check your email frequently including your junk mail box, applicants are responsible for checking their email for additional important information from us. By submitting this form, you are certifying that you have read and understand all of the above and that to the best of your knowledge the information you provided in this application is accurate, true and verifiable.