Limited scholarship opportunities are available. To learn more please contact Roy Plumlee at rplumlee@ntxad.com Automotive Technician Fast Track Program Application North Texas Automobile Dealers 5-week Fast Track Program for Automotive Technicians. Step 1 of 3 – Personal Information 33% All Applicants Must Meet The Following 5 Requirements1. Must provide transcripts and attendance records. 2. Must be able to follow the established curriculum sequence. 3. Must be a licensed driver and be insurable by employing dealership. Provide an official copy of drivers record with application. 4. Must provide personal and work references at time of application 5. Must provide a letter addressed to the NTXAD Fast Track coordinator explaining why the applicant should be considered for the program.Personal InformationName(Required) First Last Date Of Birth(Required) MM slash DD slash YYYY Drivers License Number(Required)Address(Required) Street Address City State / Province / Region ZIP / Postal Code Cell Phone(Required)Email(Required) EducationHigh School(Required)Location(Required)(City)Year Graduated or Year of G.E.D.(Required)List High School Automotive Or Other Specialized Subjects Studied In High School(Required)List Any Student Level ASE Test(s) Completed(Required)Dual Credit Courses Studied(Required) Work ExperienceList all employers within the past two years beginning with the most current.Place of Employment (1)(Required)Employer Location (1)(Required)Supervisor's Name (1)(Required)Phone Number With Area Code (1)(Required)Started Employment (1)(Required) MM slash DD slash YYYY Ended Employment (1)(Required) MM slash DD slash YYYY Reason For Leaving (1)(Required)Place of Employment (2)(Required)Supervisor's Name (2)(Required)Phone Number With Area Code (2)(Required)Employer Location (2)(Required)Started Employment (2)(Required) MM slash DD slash YYYY Ended Employment (2)(Required) MM slash DD slash YYYY ReferencesPlease provide at least one personal and one employmentReference Name (1)(Required) First Last Relationship To You (1)(Required)Phone Reference (1)(Required)Reference Name (2)(Required) First Last Relationship To You (2)(Required)Phone Reference (2)(Required)Applicant AgreementI certify that answers given on this application are true and complete to the best of my knowledge and that any misrepresentation or omission is unintentional. Furthermore, I authorize the North Texas Automobile Dealers (NTXAD) to contact my employers and references listed on this application for the purpose of investigating my education and employment records as well as my personal character to determine my eligibility and suitability for the Automotive Technician Fast Track Program. I hereby release my previous employers and all others listed on this application from all liability as a result of providing information regarding me, my employment, and my educational record. I understand that completion of this application and submission of other required documents does not in itself constitute acceptance into the Automotive Technician Fast Track Program. The Fast Track Program is a work based learning program with a NTXAD franchised dealership. NTXAD, the Fast Track Program and the college has no control over and assumes no responsibility for the dealership’s selection process or the continued employment of the student. Signature(Required)Date(Required) MM slash DD slash YYYY Consent(Required) I agree to the privacy policy.I hereby grant NTXAD personnel permission to share the information obtained by this application with the local community college and/or dealership personnel for the purpose of placing me with a sponsoring dealership. Once selected for the program, I grant NTXAD and community college personnel permission to share with my sponsoring dealership private educational information including but not limited to grades, attendance, work habits, and observed attitudes. I understand that if at any time I choose to resend permission for NTXAD or the school to share private information with my sponsor that I will be removed from the Automotive Technician Fast Track Program. PhoneThis field is for validation purposes and should be left unchanged.