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The Michigan 0999D form is a vital tool for individuals seeking employment with the Michigan Department of Transportation (MDOT). This application form is designed to collect essential information from applicants, ensuring a thorough evaluation process. It includes sections for personal details, employment history, and educational background, allowing candidates to showcase their qualifications. Notably, the form emphasizes the importance of equal opportunity, inviting applicants to disclose any disabilities to receive necessary accommodations during the application process. Additionally, it requires candidates to certify the accuracy of their information, underscoring the significance of honesty in job applications. For those with military backgrounds, the form provides a section to indicate veteran status, which can be beneficial in the hiring process. Overall, the Michigan 0999D form is structured to facilitate a comprehensive understanding of each applicant, aiding MDOT in selecting the most suitable candidates for available positions.

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of Transportation

EMPLOYMENT APPLICATION

Page 1 of 3

Michigan Department

 

0999D (01/07)

Equal Opportunity Employer

 

 

 

A MDOT APPLICATION IS REQUIRED, resumes are encouraged, but are not a substitute for the application. Submit application to Office of Human Resources, 934 Bridge Plaza, Sault Ste. Marie, Michigan 48783. Fax Number: (906) 635-0540.

POSITION FOR WHICH YOU ARE APPLYING

Posting Code: _______________________________________________ Bureau/Region/Office/Division: __________________________________

Position Location: _____________________________________________ JOB TITLE: _______________________________________________

Are you or have you ever been a State of Michigan employee?

 

Yes

 

No If Yes, Employee ID # required: _________________

If you have a disability, as defined by the Michigan Persons with Disabilities Civil Rights Act, and require assistance to complete this application, a reasonable accommodation may be provided.

PERSONAL INFORMATION

Name: __________________________________________________________________________________________________________________

Mailing Address: _________________________________________________________________________________________________________

City: _________________________________________________________________ State: _________________ Zip Code: __________________

Email Address: _______________________________________________

Drivers License Number: ______________________________________

Day Time Telephone Number: (_______) __________________________

Home Telephone Number: (_______) _____________________________

Previous name(s) if different than current name: _________________________________________________________________________________

Have you ever been dismissed from employment or resigned your employment in lieu of dismissal?

Yes

No

If Yes, when and please explain: _____________________________________________________________________________________________

NAME/LOCATION OF HIGH SCHOOL:

DIPLOMA:

Yes

No

Other (Specify) ______________

COLLEGE, UNIVERSITY, TRADE SCHOOL OR SPECIAL TRAINING: (TRANSCRIPTS ARE REQUIRED)

NAME OF SCHOOL

LOCATION

CREDIT HOURS EARNED

QTR SEM

COURSE OF STUDY

DEGREE OR CERTIFICATE RECEIVED

TRADE SCHOOL/SPECIAL TRAINING

TRADE SCHOOL/SPECIAL TRAINING

YOUR NAME, IF DIFFERENT WHILE ATTENDING SCHOOL: _____________________________________________________________________

LICENSURE OR REGISTRATION EXAMPLES: CDL, PE, CPA, ETC.

LICENSURE OR REGISTRATION

NUMBER

DATE RECEIVED

EXPIRATION DATE

STATE LICENSING AGENCY

VETERAN:

Are you a veteran, surviving spouse or a spouse of a disabled veteran who has been discharged within the last five years?

 

Yes

 

No

If yes, are you registered with Civil Service for veterans’ preference?

 

Yes

 

No

 

 

 

 

CITIZENSHIP:

Are you a U.S. Citizen?

 

Yes

 

No

 

 

 

 

 

If No, are you eligible to work in the U.S. without sponsorship?

 

 

Yes

 

No

Do you possess a valid Western Hemisphere Travel Initiative Document: ______Passport

______ Passport Card ______NEXUS ______ Other

 

 

 

 

 

If "Other", please specify: ______________________________________

MDOT 0999D (01/07)

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PERIODS OF EMPLOYMENT

Describe your work experience in detail, beginning with your current or most recent job. Include job related voluteer work, if applicable, and indicate number of employees supervised. Use a separate block to describe each position. If needed, attach additional sheets, using the same format as the application. Resumes may be attached to provide additional information.

1Name of Present or Last Employer: _______________________________________________________________________________________

Address: ___________________________________________________________________ Phone No.: (________)__________________________

Your Job Title: ________________________________________________

Supervisor’s Name: __________________________________________

FROM: _______/_______/_______ TO: _______/_______/_______

HOURS PER WEEK: _______ (________________________________)

MONTH DAY

YEAR

MONTH DAY

YEAR

YOUR NAME IF DIFFERENT DURING EMPLOYMENT

Duties and Responsibilities: _______________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

Reason for Leaving: ______________________________________________________________________________________________________________________

2Name of Present or Last Employer: _______________________________________________________________________________________

Address: ___________________________________________________________________ Phone No.: (_______)___________________________

Your Job Title: ________________________________________________

Supervisor’s Name: __________________________________________

FROM: _______/_______/_______ TO: _______/_______/_______

HOURS PER WEEK: _______ (________________________________)

MONTH DAY

YEAR

MONTH DAY

YEAR

YOUR NAME IF DIFFERENT DURING EMPLOYMENT

Duties and Responsibilities: _______________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

Reason for Leaving: ______________________________________________________________________________________________________________________

3Name of Present or Last Employer: _______________________________________________________________________________________

Address: ___________________________________________________________________ Phone No.: (________)__________________________

Your Job Title: ________________________________________________

Supervisor’s Name: __________________________________________

FROM: _______/_______/_______ TO: _______/_______/_______

HOURS PER WEEK: _______ (________________________________)

MONTH DAY

YEAR

MONTH DAY

YEAR

YOUR NAME IF DIFFERENT DURING EMPLOYMENT

Duties and Responsibilities: _______________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________

Reason for Leaving: ______________________________________________________________________________________________________________________

CERTIFICATION

I certify that all information contained in this application is true, and made in good faith. I agree and understand any falsifications, omissions, misstate- ments, or misrepresentations above will result in my forfeiting any rights of consideration for employment with the Michigan Department of Transportation or, if hired, could lead to my dismissal. Under the Michigan Persons with Disabilities Civil Rights Act, a person with a disability may allege a violation of the Act regarding the failure to accommodate only if the person with a disability notifies the employer in writing of the need for accommodation within 182 days after the date the person with a disability knew or reasonably should have known an accommodation was needed. This does not preclude my rights under federal law which establishes a 300 day status of limitation.

By submission of this application, I am authorizing the Michigan Department of Transportation to conduct a criminal history and background check, contact past employers regarding references and to check my motor vehicle operator license record as part of the pre-employment process.

SIGNATURE: ___________________________________________________________________________ DATE: _________________________

MDOT 0999D (01/07)Page 3 of 3

_EEO SURVEY

 

 

 

 

_

 

 

 

 

 

Although the following information is not mandatory, it is requested to comply with Federal Highway Administration (FHWA) require-

_

 

 

 

 

 

ments. This information is for statistical purposes only. It will in no way affect your employment status or opportunities, nor will it be

_

 

 

 

 

 

used as part of the selection process (hiring managers will not receive this information).

___Posting Code: _______________________________________________

Bureau/Region/Office/Division: __________________________________

__Position: ___________________________________________________

Location of Position___________________________________________

____

 

MALE

 

FEMALE

 

GENDER:

 

 

 

____

 

 

 

 

 

DISABLED:

 

NO

 

YES

 

__

 

 

 

 

 

process._ __

__ selection_ __

the__ to__

prior_ __ section_ __

this__

remove__ __

Employer,__

_

__ _ _

RACE/ETHNICITY (Please select all that apply to you):

American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America).

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black: (not of HISpanic origin): A person having origins in any of the black racial groups.

Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish origin.

Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White (not of Hispanic origin): A person having origins in any of the original peoples of Europe, North Africa, or Middle East.

Multiracial: A person having origins in more than one racial group.

Form Specifications

Fact Name Description
Form Purpose The Michigan 0999D form is an employment application used by the Michigan Department of Transportation (MDOT) for job applicants.
Submission Details Applicants must submit the completed form to the Office of Human Resources located at 934 Bridge Plaza, Sault Ste. Marie, Michigan 48783.
Resumes While resumes are encouraged, they do not replace the need for completing the application form itself.
Equal Opportunity Employer MDOT is committed to equal opportunity in employment, ensuring fair treatment for all applicants.
Disability Accommodations Under the Michigan Persons with Disabilities Civil Rights Act, reasonable accommodations may be provided for applicants with disabilities.
Background Checks By submitting the application, candidates authorize MDOT to conduct background checks, including criminal history and reference checks.
Governing Laws This form is governed by the Michigan Persons with Disabilities Civil Rights Act and federal employment laws.

Michigan 0999D: Usage Guidelines

Completing the Michigan 0999D form requires careful attention to detail. This application is essential for those seeking employment with the Michigan Department of Transportation. Follow these steps to ensure that your application is filled out correctly and completely.

  1. Begin by entering the Position for which you are applying. Fill in the Posting Code, Bureau/Region/Office/Division, and Position Location.
  2. Indicate the Job Title you are applying for.
  3. Answer whether you are or have ever been a State of Michigan employee. If yes, provide your Employee ID number.
  4. If you have a disability and need assistance, note that a reasonable accommodation may be provided.
  5. Complete the Personal Information section with your name, mailing address, city, state, zip code, email address, driver's license number, daytime telephone number, and home telephone number.
  6. If you have had a previous name, list it under Previous name(s).
  7. Respond to the question regarding dismissal from employment or resignation in lieu of dismissal, including an explanation if applicable.
  8. Provide details about your high school education, including the name/location and whether you received a diploma.
  9. List any college, university, trade school, or special training attended. Include the name of the school, location, credit hours earned, course of study, and degree or certificate received.
  10. Provide any relevant licensure or registration details, including numbers and expiration dates.
  11. Indicate if you are a veteran, surviving spouse, or spouse of a disabled veteran, and whether you are registered for veterans’ preference.
  12. Confirm your citizenship status and provide details regarding eligibility to work in the U.S.
  13. Detail your Periods of Employment starting with your most recent job. Include the employer's name, address, phone number, your job title, supervisor’s name, employment dates, hours worked per week, and duties/responsibilities for each position.
  14. For each job, explain your reason for leaving.
  15. In the Certification section, read and agree to the statements regarding the accuracy of your information and the potential for background checks.
  16. Sign and date the application.
  17. Complete the optional EEO Survey section for statistical purposes, if desired.

Your Questions, Answered

What is the Michigan 0999D form used for?

The Michigan 0999D form is an employment application used by the Michigan Department of Transportation (MDOT). It is required for anyone applying for a position within the department. While resumes are encouraged, they cannot replace the application form itself. Completing this form accurately is essential for consideration for employment.

Where should I submit my completed Michigan 0999D form?

You should submit your completed Michigan 0999D form to the Office of Human Resources at 934 Bridge Plaza, Sault Ste. Marie, Michigan 48783. If you prefer, you can also fax your application to (906) 635-0540. Make sure to double-check that all required sections are filled out before submission to avoid delays.

What information do I need to provide on the Michigan 0999D form?

The form requires personal information such as your name, mailing address, and contact details. You will also need to provide details about your employment history, including job titles, responsibilities, and reasons for leaving previous jobs. Additionally, educational background, licenses, and veteran status must be included. Ensure all sections are completed thoroughly.

Can I request assistance if I have a disability?

If you have a disability as defined by the Michigan Persons with Disabilities Civil Rights Act, you can request reasonable accommodations to help you complete the application. It is important to notify the employer in writing about your need for assistance within 182 days of knowing you require it. This ensures you receive the support you need during the application process.

What happens if I provide false information on the application?

Providing false information on the Michigan 0999D form can have serious consequences. Any inaccuracies, omissions, or misrepresentations may lead to disqualification from consideration for employment. If you are hired and it is later discovered that you provided false information, it could result in your dismissal from the position. Always ensure that the information you provide is truthful and accurate.

Common mistakes

  1. Incomplete Personal Information: Many applicants forget to fill out all sections of their personal information, such as mailing address or phone numbers. This can lead to communication issues later on.

  2. Missing Employment Dates: Failing to include accurate start and end dates for previous jobs can create confusion. It's essential to provide a clear timeline of your work history.

  3. Not Specifying Job Titles: Some individuals skip listing their job titles or provide vague descriptions. Clear job titles help employers understand your experience better.

  4. Omitting Supervisor Information: Forgetting to include the name of a supervisor can hinder reference checks. Always provide this information to support your application.

  5. Ignoring the Certification Section: Applicants sometimes overlook the certification statement at the end. This section confirms the truthfulness of the application and is crucial for consideration.

  6. Neglecting to Attach Required Documents: Failing to include transcripts or other required documents can result in an incomplete application. Always double-check the requirements before submission.

  7. Not Proofreading: Typos and grammatical errors can create a negative impression. Taking the time to proofread can enhance the professionalism of your application.

  8. Forgetting to Sign and Date: Some applicants forget to sign and date the application. This step is essential, as it indicates your acknowledgment of the information provided.

Documents used along the form

The Michigan 0999D form is an employment application used by the Michigan Department of Transportation. When applying for a position, several other forms and documents may be necessary to support your application. Below is a list of related documents that are often used alongside the 0999D form.

  • Resume: A detailed summary of your work experience, education, and skills. While not a substitute for the application, it can provide additional context about your qualifications.
  • Transcripts: Official records from educational institutions that detail your courses, grades, and degrees earned. These may be required to verify your educational background.
  • Cover Letter: A letter that introduces you and explains why you are interested in the position. It allows you to highlight specific experiences that make you a good fit for the role.
  • Veteran’s Preference Documentation: If you are a veteran or the spouse of a veteran, you may need to provide documentation to claim preference in hiring, as outlined by state regulations.
  • Licensure or Certification Documents: Copies of any relevant licenses or certifications that are required for the job. This could include a Commercial Driver’s License (CDL) or professional certifications.
  • Background Check Authorization: A form that gives the employer permission to conduct a background check. This is often part of the pre-employment process.
  • Disability Accommodation Request: If you require assistance due to a disability, you may need to submit a request for reasonable accommodations along with your application.

Gathering these documents can help streamline your application process and ensure that you meet all necessary requirements. Make sure to review each document carefully before submission to present a complete and accurate application.

Similar forms

The Michigan 0999D form is an employment application used by the Michigan Department of Transportation (MDOT). Several other documents serve similar purposes in various contexts. Below is a list of nine documents that share similarities with the Michigan 0999D form, along with explanations of how they are alike.

  • Federal Employment Application (SF-171): This form is used for federal job applications. Like the Michigan 0999D, it collects personal information, work history, and qualifications to assess candidates for employment.
  • State Employment Application (STD. 678): Similar to the Michigan 0999D, this application is used by various state agencies in California. It includes sections for personal information, employment history, and education.
  • Job Application for Private Sector Employment: Many companies use standardized job applications that request similar information, such as work experience, education, and references, just like the 0999D form.
  • Resume: While a resume is not a formal application, it often accompanies applications like the Michigan 0999D. Both documents aim to showcase qualifications and experience to potential employers.
  • Volunteer Application Form: Non-profit organizations often use volunteer applications that request personal information and experience. This is similar to how the 0999D gathers relevant details for employment consideration.
  • College Admission Application: Colleges and universities collect personal information, educational history, and extracurricular activities in their admission applications, paralleling the structure of the Michigan 0999D form.
  • Internship Application Form: Many organizations have specific forms for internship applications that gather similar information about education, skills, and work experience, akin to the 0999D form.
  • Background Check Authorization Form: This document is often required alongside job applications. It requests permission to conduct background checks, similar to the consent given in the 0999D for checking criminal history.
  • Professional License Application: Applications for professional licenses, such as those for nurses or teachers, often require detailed personal and educational information, much like the Michigan 0999D form does for job applicants.

Dos and Don'ts

When filling out the Michigan 0999D form, there are several important dos and don'ts to keep in mind to ensure your application is processed smoothly.

  • Do read the entire application carefully before starting.
  • Do provide complete and accurate information in all sections.
  • Do include your current or most recent job first when detailing employment history.
  • Do attach any required transcripts or additional sheets if necessary.
  • Don't leave any sections blank unless instructed otherwise.
  • Don't submit a resume as a substitute for the application; it should accompany it instead.
  • Don't provide false information, as this could jeopardize your application or employment.

Misconceptions

  • Misconception 1: The Michigan 0999D form is only for current state employees.
  • This form is designed for anyone applying for a position with the Michigan Department of Transportation, regardless of their current employment status. Previous state employees must provide their Employee ID, but new applicants are also welcome.

  • Misconception 2: Submitting a resume is enough; the application form is optional.
  • While resumes are encouraged, they do not replace the necessity of completing the application form. The 0999D form collects specific information required for the hiring process.

  • Misconception 3: Only certain disabilities qualify for accommodations.
  • Under the Michigan Persons with Disabilities Civil Rights Act, any disability as defined by the law may warrant accommodations. Applicants are encouraged to communicate their needs clearly.

  • Misconception 4: The application is not subject to background checks.
  • Submitting the 0999D form authorizes the Michigan Department of Transportation to conduct background checks, including criminal history and motor vehicle records. This is a standard part of the hiring process.

  • Misconception 5: The personal information section is optional.
  • While some information may not be mandatory, providing complete personal information is essential for processing the application effectively.

  • Misconception 6: The EEO survey affects hiring decisions.
  • The EEO survey is for statistical purposes only and does not influence the selection process. Hiring managers do not see this information.

  • Misconception 7: The application does not require detailed job descriptions.
  • Applicants must provide detailed descriptions of their work experience, including duties and responsibilities. This information helps assess qualifications for the position.

  • Misconception 8: Previous names do not need to be disclosed.
  • If an applicant has changed their name, it is important to include previous names on the form. This helps ensure that all records can be accurately matched during the background check.

Key takeaways

Here are some key takeaways regarding the Michigan 0999D form:

  • Application Requirement: A completed MDOT application is mandatory. Resumes may be submitted but will not replace the application.
  • Submission Details: Applications must be sent to the Office of Human Resources at the specified address in Sault Ste. Marie, Michigan.
  • Position Information: Clearly indicate the job title, posting code, and location for which you are applying.
  • Employment History: Provide detailed descriptions of your work experience, including volunteer work, if relevant.
  • Education Records: Transcripts are required for any college, university, or trade school attended.
  • Licensure Information: Include any relevant licenses or registrations, along with their numbers and expiration dates.
  • Veteran Status: Indicate if you are a veteran or a spouse of a disabled veteran, as this may affect your application.
  • Citizenship Status: Confirm your citizenship status and ability to work in the U.S. without sponsorship.
  • Certification: Sign the application to certify that all information provided is accurate and complete.
  • EEO Survey: Participation in the Equal Employment Opportunity survey is voluntary and does not impact employment decisions.