Equipment RSVP

Equipment RSVP
To prevent the spread of COVID-19 and reduce the potential risk of exposure to our workforce and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in this building. Thank you for your time.
CJAT COVID-19 Questionnaire
Name *

First Name Last Name
Today's Date *

Month Day Year
Date
Phone Number *

Area Code Phone Number
E-mail/ Optional
Have you returned from any of the countries listed on Coronavirus FAQs within the last 14 days? *

Yes No
Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days? *

Yes No
Have you experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough, sore throat, respiratory illness, difficulty breathing)? *

Yes No
Have you been in close contact with anyone who has experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough, sore throat, respiratory illness, difficulty breathing)? EXAMPLE: Spouse, Children, sibling, your roommate or anyone else *

Yes No
If the answer is “yes” to any of the questions, access to the CJAT facility will be denied. If you attend without completing this questionnaire you will be denied access. If you attend and are suspected of being sick you will be asked to leave.
Signature *

Name *

First Name Last Name
Check here if you are planning to train on the CDL Truck:

CDL Training
IUOE L9 Membership Type *

Apprentice Journeyman
Reservation Date *

Month Day Year
Date
Equipment Requested. *
I understand that I accept the risk of exposure to the COVID-19 virus by attending the training site. I may leave if I feel exposed. I further vow that I am not ill and have had no known contact with anyone who has been exposed to the COVID-19 Virus.

I further understand that I may not get the piece of equipment I requested and I will be flexible and work with the Instructors at the site.

By clicking on submit I realize that, if Approved I am one of the few that are allowed to train on the day requested. Many others may not be approved once the limited slots are full. If I do not show on the RSVP date, someone else who would have shown may have been rejected.
I agree *

Yes
Should be Empty:

CJAT COVID-19 Questionnaire