Form OJT-3 "Training Completion Report" - Mississippi

What Is Form OJT-3?

This is a legal form that was released by the Mississippi Department of Transportation - a government authority operating within Mississippi. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 5, 2015;
  • The latest edition provided by the Mississippi Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form OJT-3 by clicking the link below or browse more documents and templates provided by the Mississippi Department of Transportation.

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MISSOURI DEPARTMENT OF TRANSPORTATION
TRAINING COMPLETION REPORT
No
Yes
TRAINEE NAME
UNION
HOME ADDRESS
CRAFT
CITY/STATE/ZIP
UNION NAME
HOME PHONE
CONTRACTOR
SSN# (LAST 4-DIGITS)
GENDER
Male
Female
NO. OF TRAINEE HOURS COMPLETED TO DATE - ALL PROJECTS
ETHNIC BACKGROUND
NATIVE AMERICAN
HISPANIC
AFRICAN AMERICAN
ASIAN AMERICAN
CAUCASIAN
OTHER DISADVANTAGED
TRAINING INFORMATION
COUNTY
ROUTE
FEDERAL-AID PROJECT
JOB NUMBER
HOURS
DATES OF TRAINING
BEGINNING DATE
ENDING DATE
REASON FOR TERMINATION
Completed Program; retained as Journeyperson
Yes
No
Illness
Job Completion
Fired
Seasonal Layoff
Personal or health problems
Quit to work for another company
Strike, work stoppage, did not return
Transferred to Job No.
Lack of transportation and/or travel distance
Other (comment below)
COMMENTS ON TRAINEE'S PERFORMANCE
CONTRACTOR ELECTRONIC SIGNATURE
DATE
ORG CODE
DATE
SIGNATURE OF MoDOT REPRESENTATIVE
DISTRIBUTION: SUBMIT BY EMAIL TO YOUR PROJECT OFFICE CONTACT. PROJECT OFFICE - DISTRIBUTE ELECTRONICALLY TO ECR AND
CONTRACT FILE
OJT-3 Rev. 8/5/15
Print Form
MISSOURI DEPARTMENT OF TRANSPORTATION
TRAINING COMPLETION REPORT
No
Yes
TRAINEE NAME
UNION
HOME ADDRESS
CRAFT
CITY/STATE/ZIP
UNION NAME
HOME PHONE
CONTRACTOR
SSN# (LAST 4-DIGITS)
GENDER
Male
Female
NO. OF TRAINEE HOURS COMPLETED TO DATE - ALL PROJECTS
ETHNIC BACKGROUND
NATIVE AMERICAN
HISPANIC
AFRICAN AMERICAN
ASIAN AMERICAN
CAUCASIAN
OTHER DISADVANTAGED
TRAINING INFORMATION
COUNTY
ROUTE
FEDERAL-AID PROJECT
JOB NUMBER
HOURS
DATES OF TRAINING
BEGINNING DATE
ENDING DATE
REASON FOR TERMINATION
Completed Program; retained as Journeyperson
Yes
No
Illness
Job Completion
Fired
Seasonal Layoff
Personal or health problems
Quit to work for another company
Strike, work stoppage, did not return
Transferred to Job No.
Lack of transportation and/or travel distance
Other (comment below)
COMMENTS ON TRAINEE'S PERFORMANCE
CONTRACTOR ELECTRONIC SIGNATURE
DATE
ORG CODE
DATE
SIGNATURE OF MoDOT REPRESENTATIVE
DISTRIBUTION: SUBMIT BY EMAIL TO YOUR PROJECT OFFICE CONTACT. PROJECT OFFICE - DISTRIBUTE ELECTRONICALLY TO ECR AND
CONTRACT FILE
OJT-3 Rev. 8/5/15
Print Form