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Office of Operations Administrative Services
Civil Engineer/Technician Student Co-op Program Application
Note: In order to be considered for this program your current college TRANSCRIPT must be attached to this application. Applications received without a transcript will not be considered.
* = Required Fields
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As provided by the applicable state and federal regulations, I require accommodation of a disability to participate in this program?

The following information is used for statistical purposes only:
 
Legal right to work in the United States:
*
Contact Information:
*
* (Street):
* * *
* -Area Code and Number: - -

Alternate Contact Information:
(Street):
-Area Code and Number: - -
College Information:
*

*
*   *
* Calendar
*   (Click Browse to select a file. Attachment type must be an Adobe Acrobat PDF document.)
*
*
*   (Click Browse to select a file. Attachment type must be an Adobe Acrobat PDF document.)
*
Driver's License:
*
* (format: A-123-456-789-012)
*
Calendar
* Mail your official driving records to the address below. Failure to provide your driving records will result in the denial of your application.

Michigan Department of Transportation
Office of Human Resources
Co-op Program - DL
P.O. Box 30050
Lansing, MI 48909
Please select dates you are available for employment.
* Calendar     * Calendar
*
* * Note: Enter only digits. If unknown, enter 0 (zero).
* Have you ever participated in any of the following MDOT programs?
(Limit 200 Characters)

Work Location Preference:
* *
* Criminal History: (Please check all that apply)
Convicted of a felony (provide date, offense, location and disposition below) Convicted of a misdemeanor (provide date, offense, location and disposition below)
Felony Criminal charges are pending (please explain below) None
Please list each offense, date of offense, location and disposition/explanation (limit 500 characters):
*
     
DISCLAIMER: Your application for this program does not guarantee that you will be contacted for further consideration.
* = Required Fields

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