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					                                       County of Volusia
                             Training and Experience Questionnaire
NAME_________________________________                    Residence Phone Number (           )       -

THE YEARS OF EXPERIENCE MUST BE REFLECTED IN JOB HISTORY ON YOUR APPLICATION

1.     Do you have a valid Florida Driver License? [ ] yes [ ] No
2.     Do you have a valid Florida Commercial Driver License? [ ] yes [ ] No
3.     What level of Commercial Drivers License do you have? [A] [B] [C] [D]
4.     What endorsement codes do you have?[T] [N] [P] [H] [X]
5.     Please circle which side of the County you prefer to report?
           • East              (Daytona, Ormond, New Smyrna, Port Orange, Edgewater, Oak Hill, Holly Hill)
           • West               (Deland, Osteen, Deltona, Pierson, Orange City, Debary, Deleon Springs)
           • No Preference
                                             MAINTENANCE WORKER
           Knowledge, Skills, Ability                yrs/mos            Knowledge, Skills, Ability      yrs/mos
 Truck-mounted insect spray equipment                    /      Electric waxer                              /
 Ditch cleaning hand tools                               /      Light equipment maintenance                 /
 Using cleaning products and equipment                   /      Brush cutter                                /
 Set up and/or move equipment or furniture               /      Assist in brick laying                      /
 Grounds maintenance                                     /      Power mower                                 /
 Light electrical, painting or other construction        /      Ballfield machine                           /
 Operate a tractor in landscaping project                /      Turf maintenance                            /
                                              EQUIPMENT OPERATOR
During the last 10 years:
1. How many traffic violations have you had? _______
2. How many of these were moving violations? _______
3. How many involved accidents where you were found at fault? _______

     EQUIPMENT OPERATOR I               EQUIPMENT OPERATOR II                 EQUIPMENT OPERATOR III
     Knowledge, Skills,    yrs/mos        Knowledge, Skills,      yrs/mos       Knowledge, Skills,  yrs/mos
            Ability                             Ability                               Ability
 Tractor/sickle bar,           /        Tractor with front loader     /      Crane                     /
  pull or move                                                               Track Back Hoe            /
 equipment/machinery                                                         Bucket truck              /
 Operate a chain saw or        /        Backhoe with less than        /      Pavement striping         /
 concrete saw                           1 yd. bucket                         machine-truck mounted
 Pumping equipment             /        Rotary crane on treads        /      Motor grader              /
 Fuel truck/service            /        Vehicle mounted power         /      Heavy bulldozer           /
 equipment with fuel                    spraying                             Compactor                 /
 Tank wagon                    /        Boom-type mower               /      Lo boy/tractor trailer     /
 Vehicle mounted cement        /        Tandem/tri-axle dump          /      Vac Truck                 /
 mixer, air compressor,                 truck
 hammer                                 Off road dump truck           /      Off road dump truck           /
 Flat-bed/single-axle dump     /        Road roller/soil              /      Hydraulic excavator           /
 truck 8,000 lbs. +                     stabilizer                           (boom/gradall)
 Fork lift                     /        Chipper/Stump Grinder         /      Dragline                      /
 Lift station                  /        Clam Truck                    /      Front-end loader              /
                                                                             with 4 yd.bucket

THE YEARS OF EXPERIENCE MUST BE REFLECTED IN JOB HISTORY ON YOUR APPLICATION
      CARPENTRY I, II, III                     ELECTRICAL I, II, III                              HVAC I, II, III
 Knowledge, Skills, Ability yrs/mos          Knowledge, Skills, yrs/mos                   Knowledge, Skills,      yrs/mos
                                                  Ability                                        Ability
 Hang doors/knocked down            /      Bend conduit              /                Change compressor and           /
                                                                                      motors
 Hang doors/pre-hung                /      Size conduit                       /       Install A/C units, split        /
                                                                                      and package
 Complete framing/layout            /      Size load centers                  /       Fit all sizes of copper         /
 Suspended ceilings                 /      Wiring for lighting                /       pipe
 Finish work                        /      Size conductors                    /       Trouble shoot electric          /
                                                                                      circuits
 Cabinets                           /      Read blue prints                   /       Make and install duct           /
 Metal studs                        /      Low voltage control                /       work
 Formica                            /      Control wiring                     /       Read blueprints                 /
 Hang drywall                       /      Trouble shoot electrical           /       Install & work on               /
                                           problems                                   refrigeration units

       PAINTING I, II, III                          PLUMBER I, II, III                   CONSTRUCTION I, II, III
    Knowledge, Skills,    yrs/mos                Knowledge, Skills, yrs/mos              Knowledge, Skills, yrs/mos
        Ability                                      Ability                                 Ability
 Brush & roller application         /               Layout & Dig
                                           Pipe sizes & fittings              /                                     /
                                                    foundations
Scaffolding               / Solder, silver solder / Form structures by                                              /
assemble/disassemble                                cutting wood
Airless spray             / Cut & thread pipe     / Sets reinforcing steel                                          /
Prep work (caulking,      / Rough in plumbing     / Mixes materials                                                 /
patching, etc.)                                     including sand, cement,
                                                    rock, etc.
Pressure cleaning         / Set fixtures          / Pour & finishes cement                                          /
Use of oil, acrylic, etc. / Repair fixtures       / Lays brick/concrete                                             /
                                                    block
                          / Sanitary sewers       / Sets grades for drainage                                        /
                            Water distribution    / pipes
                          / Plumbing codes        / Lays pipe to grade                                              /
                          / Read blueprints       / Builds sandbag                                                  /
                            Layout work           / headwalls
                          / Underground           / Repairs failed concrete                                         /
                            water/sewer             structures
WRITE THE NUMBER OF YEARS EXPERIENCE YOU HAVE IN EACH AREA OF WELDING:

•Tig Welding         •Mig Welding              •Welding and Fabrication           •Brazing       •Cutting Torch_______

•Plasma         •CuttingScarfer (Carbon Arc)            •Aluminum Spool Gun             •Knowledge of Metal Types_______

I CERTIFY THAT THE INFORMATION PROVIDED ON THIS FORM IS COMPLETE AND TRUE TO THE BEST OF MY
KNOWLEDGE AND I UNDERSTAND THAT FALSIFICATION OF THIS INFORMATION MAY BE GROUNDS FOR
DISQUALIFICATION FOR EMPLOYMENT WITH VOLUSIA COUNTY OR TERMINATION, IF EMPLOYED.
MY APPLICATION REFLECTS MY WORK EXPERIENCE.

________________________________________                                          _________________________
SIGNATURE                                                                         DATE