Tri Counties Sheet Metal Worker's JATC
Local Union No. 104 - District 3 Apprenticeship
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Info:
Prefix:
First name:
*
Middle name:
Last name:
*
Suffix:
Nickname:
Date of birth:
SSN:
Drivers license number:
Gender:
Male
Female
Ethnicity:
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Veteran:
Yes
No
Disabled
Street:
Street 2:
City:
State:
Zip code:
Address type:
Business
Home
Primary phone number:
Primary phone type:
Cell
Fax
Home
Office
Other
Pager
Work
Secondary phone number:
Secondary phone type:
Cell
Fax
Home
Office
Other
Pager
Work
Email:
Email address type:
Home
PDA
Work
Answers:
Education
Education
1. Enter one of the following selections to indicate years of formal education you have completed. Less than 10, 10, 11, 12, 13, 14, 15, 16, 17, 18, More than 18.
*
2. Are you a High School graduate?
*
Yes
No
2a. If no, do you have a GED?
Yes
No
3. List degrees you have earned. (Incude degree, major, and school)
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4. Did you satisfactorily complete and receive credit for Algebra 1 (or some higher math) in High School or in Post High School?
Yes
No
4a. If so, what Institution?
5. Did you ever participate in any kind of vocational technical training during or after High School?
*
Yes
No
5a. If yes, how long was the program? (# of months)
5b. Describe the program?
5c. Did you complete the program?
Yes
No
6. Did you ever participate in any kind of School-to-work program when you were in school?
Yes
No
Backround
BACKROUND
7. Have you served in the U.S. Military?
*
Yes
No
7a. If yes, how long? (# of months)
7b. What Branch of Military?
7c. What military training schools did you complete, if any?
8. Have you ever been convicted of a felony?
*
Yes
No
8a. If yes, explain the conviction:
9. Do you have sheet metal work experience?
*
Yes
No
10. Do you have experience in any kind of construction work?
*
Yes
No
11. Have you applied with this apprentice progam before?
*
Yes
No
11a. If yes, how many times?
11b. If yes, what year(s)?
12. Have you ever applied for apprenticeship in any other trade or occupation?
*
Yes
No
13. Do your have a valid Driver's License?
*
Yes
No
Interests
INTERESTS
14. How did you hear about this program?
*
School Counselor
Newspaper
From Someone In The Trade
Radio/TV
Word of Mouth
Other
14a. If other, please explain.
15. List some reasons why you are applying for this apprenticeship.
*
16. Give a brief description of the kind of work you think is involved with this trade.
*
Ability
ABILITY
17. Are you physically and mentally able to safely perform the work of this trade, either with or without reasonable accommodations?
*
Yes
No
18. Are you able to get to and from work at various job sites anywhere within the geographical area that this apprenticeship program covers?
*
Yes
No
19. Are you able and willing to attend all related classroom training as required to complete your apprenticeship?
*
Yes
No
20. Are you able to climb and work from ladders, scaffolds and man lifts (all types)?
*
Yes
No
21.Can you crawl and work in confined spaces such as attics, crawl spaces and inside various equipment?
*
Yes
No
22. Are you able to read and understand English?
*
Yes
No
23. Are you able to hear and understand verbal instructions and warnings given in English?
*
Yes
No
Work History
WORK HISTORY
24. Are you presently employed?
Yes
No
24a. If yes, do you request that we not contact your present employer?
Yes
No
25. Do you have the legal right to work in the U.S.?
*
Yes
No
25a. If yes can you furnish proof? (i.e. birth certificate, visa, etc.)
Yes
No
Previous Employers
List all employers; begin with your present or most recent employer
provide dates (From and To) to show how long you were employed with each employer:
Employer (1)
Address, City, State, Zip
Dates of Employment
Job Title and type of work performed
Reason for leaving.
Employer (2)
Address, City, State, Zip
Dates of Employment
Job Title and type of work performed
Reason for leaving
Employer (3)
Address, City, State, Zip
Dates of Employment
Job Title and type of work performed
Reason for leaving
26. Do you realize it is impossible to guarantee full employment in the Sheet Metal Industry?
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27. Do you realize that increases in pay are not automatic, but depend on the progress made by the apprentice on the job and in school?
Yes
No
28.Do you have the legal right to work in the United States of America?
*
Yes
No
Terms and Conditions
TERMS AND CONDITIONS
Understanding all of the above and stating that, to the best of my knowledge, all information provided on this form is true and accurate.
*
Yes
No
If selected I will abide by all standards, Rules and Policies Covered by the indenture (apprenticeship agreement).
*
Yes
No
