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OR APPROVED BY DATEPERMIT MECHANIC TRAINEE APPLICATION ONLY. Read instructions before completing. Please TYPE or PRINT. 1. NAME (First) 3. HOME ADDRESS (Middle) (Last) (Street) 2. BIRTH DATE (City) (County) 4. CONTACT TELEPHONE # 5. DRIVER LICENSE OR ID NUMBER 8 or under 9 6. EMAIL ADDRESS 10 11 12 GED (Month) (Day) (State) (Year) (Zip) 7. SOCIAL SECURITY NUMBER 8. If you are now employed or soon will be employed at a repair facility, give name and address of facility: 10.

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