Modoc Railroad Academy School - Railroad Training Center - Railroad Academy

Modoc Railroad Academy .......AMERICA'S #1 RAILROAD ACADEMY......./........

New legislation passed regarding current conductors >>
> Learn more about the Railroad Safety Improvement Act of 2008 Conductor Certification Program.

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MODOC RAILROAD ACADEMY
Pre-application for Student Training

All information within this application must be true and accurate. Information must be verifiable for acceptance by Modoc Railroad Academy as a student. Enrollment is not confirmed until application is approved and payment is received.

Last Name:		Middle Initial:
First Name:
Address (mailing address):		City:
State:		Zip Code:
Home Phone:		Additional Phone:

Email Address:
Confirm Email:

Marital Status: Married Single	If Married, Name of Spouse and contact number: Contact Number: Name of Spouse:
Currently Employed? No: Yes:	If yes, name of current employer:
Current Age:

1. Can you read, write and speak English clearly?			Yes No
2. Are you a high school graduate or do you have a GED?			Yes No
3. Do you have a current valid driver's license?			Yes No
4. Have you ever been convicted of D.W.I. or D.U.I.? 4a. If yes, when:			Yes No
5. Is your vision correctable to 20/40?			Yes No
6. Have you ever been certified to drive a commercial vehicle?			Yes No
7. Are you color blind?			Yes No
8. Do you have any hearing problems?			Yes No
9. Do you take any prescribed medication?			Yes No
10. Do you have any physical or mental disabilities?			Yes No
11. Are you presently employed either part time or full time?			Yes No
12. Can you verify employment / education history?			Yes No
13. Can you show proof of eligibility to work in the United States?			Yes No
14. Have you sustained an on the job injury and/ or paid worker's compensation?			Yes No
15. Will you agree to a random drug test?			Yes No
16. Are you under indictment, probation or charged with any crime?			Yes No
17. Have you been convicted of any felony within the past 7 years? If yes, note that many railroads do not offer employment to persons with a felony record within the last seven years. You should call the school to discuss your situation.			Yes No
18. How did you hear about the Modoc Railroad Academy?
Program Options:
19. Which Program would you like to enroll in? Conductor Class Only: Conductor & Engineer Class: If you are choosing this option you must enroll in either the May or September Conductor Class which will be immediately followed by the Engineer Class.			Note: In order to enroll in the Locomotive Engineer program, you must successfully complete the Conductor program and receive your Conductor card. If you would like to take the Conductor class and Engineer class successively you will need to enroll in either the May or September Conductor Class. If you are already a Conductor who wishes to take the Engineer Class only, please contact the school by phone to discuss your particular circumstances.
I would like to reserve space in the following Conductor class: Year: Month:			Need to double check the schedule? Click here
CONDUCTOR STUDENTS: I UNDERSTAND THAT A MANDATORY $100 NON-REFUNDABLE DEPOSIT AND $15.00 ONLINE APPLICATION FEE MUST BE INCLUDED WITH THIS CONDUCTOR PROGRAM APPLICATION TO PROCESS THIS APPLICATION. I ALSO CERTIFY THE ABOVE INFORMATION IS TRUE.

Modoc Railroad Academy Conductor Program Cost Breakdown
EFFECTIVE 1-1-2011 Section One: Certified Conductor Two weeks instruction $1000 Text books - non refundable $392 Section Two: Certified Conductor Two weeks instruction $1000 Section Three: Certified Conductor Two weeks instruction $1000 Section Four: Certified Conductor Two weeks instruction $1000 Lab fee $1000 Conductor Certification $1000
Housing, meals and transportation are not included. It is strongly advised that if you plan to attend the Modoc Railroad Academy, you make an advance trip a month or more before you start class to familiarize yourself wi th local housing sites, supermarkets and medical centers. The Modoc Railroad Academy makes NO RECOMMENDATIONS ON HOUSING. Are you taking the Locomotive Engineer Class also? There is a separate tuition and class timetable for engineer classes.
Applicant: By submitting this application you will be directed to pay the $115.00 deposit & processing fee or the entire tuition amount on the next page.