Michigan City Resident Local Hiring Program Registration Form Page 2
ADVERTISEMENT
1
2REGISTRATION FORM
MICHIGAN CITY RESIDENT LOCAL HIRING PROGRAM
“Whereas the city of Michigan City is a diverse and talented community of skilled workers, craft persons,
and laborers… One of the goals of the local hiring program is to encourage the hiring of local residents,
minorities and women on construction projects.”
Ordinance No. 3974
T
C
R
. Y
M
C
HIS APPLICATION IS FOR
ITY
ESIDENTS ONLY
OU MUST BE A RESIDENT OF
ICHIGAN
ITY FOR A MINIMUM OF
6
.
MONTHS IN ORDER TO QUALIFY FOR PUBLICALLY FUNDED JOBS
First Name: ________________ Last Name: ______________________ M.I.: _______
Physical Address: ________________________________ City, State, Zip: ________________
*If using a PO Box as mailing address you MUST list your physical address above to be included on the registry.
P.O. Box: ___________________________ City, State, Zip: ________________________________
Home Telephone Number: (___) __________________
Other Phone number: (__) _________
Email: ______________________________
_______ I am a female seeking employment.
_______ I am a minority seeking employment.
___________________________ Specify Race or Ethnicity (optional)
Member of a union?
Yes
No If yes, which one? _________________________
Please list your trade:
Iron worker
Boilermaker
Other_____________________
Cement Worker
Carpenter
General laborer
Plumber
Electrician
Roofer
Insulation Worker
Glaziers
List any additional special qualifications and/or certifications.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please return this completed form to:
Michigan City Human Rights Department
100 East Michigan Boulevard
Michigan City, IN 46360
Phone: (219) 873-1429 Fax: (219) 873-1562
DATE: ______________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal