IW 380 APPLICATION FOR APPRENTICESHIP

APPLICATION FOR APPRENTICESHIP

THIS FORM MUST BE COMPLETED IN ITS ENTIRETY BY THE APPLICANT
Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Please enter a valid phone number.
Email
example@example.com
NAME CHANGE: Please provide the name that will appear on documents or transcripts that you submit, if it is different than your present name: PREVIOUS NAME:
Do you have a valid drivers license?

YesNo
Drivers License Number
State
Expiration Date

MonthDayYear
Date
Are you able to legally work in the United States?

YesNo
Education

You Must Supply All Transcripts As Required
How many years of formal education have you completed?

Less than 10101112131415161718More than 18
Are you a High School Graduate?

YesNo
If no do you have a GED?

YesNo
Name of High School attended?
Address of High School attended:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of graduation:

MonthDayYear
Date
List the Degree's you have earned along with your major and school:
Did you satisfactorily complete and receive credit for Algebra I (or some higher math) in high school or in a post high school institution?

YesNo
Have you completed a registered Pre-Apprenticeship Program?

YesNo
If yes, list the program
Did you ever participate in any kind of vocational technical training during or after high school?

YesNo
If Yes, How long was the program?
Months
Describe the program:
Did you complete the program?

YesNo
Did you ever participate in any kind of school-to-work (co-op education) program when you were in school?

YesNo
If yes, describe the program.
Did you obtain full time employment (placement) in a related field upon completion of the program?

YesNo
Backround
Have you served in the US Military?

YesNo
If yes, how long?
months
What Branch?
What Military school did you complete, if any?
What type of discharge did you receive?
Do you have ironwork experience?

YesNo
Do you have experience in any kind of construction work?

YesNo
Do you have any experience in any ironwork related field?

YesNo
Have you ever applied for apprenticeship in any other trade?

YesNo
If yes, how many times?
If yes, what year(s)?
Have you ever applied for apprenticeship in any other trade?

YesNo
Have you participated in an apprenticeship of any kind?

YesNo
If yes, what apprenticeship?
Are you currently serving an apprenticeship?

YesNo
If yes, list the employer or apprenticeship sponsor?
Do you have a Commercial Driver's License (CDL)?

YesNo
If yes, what class CDL do you have?
Interest
How did you learn about this program?

School CounselorRadio / TVNewspaperWord of MouthThrough a Pre-Apprenticeship ProgramFrom Someone in the TradeJob PlacementOther
List some reasons why you are applying for this apprenticeship program:
Give a brief description of the kind of work you think is involved with this trade:
Why would you want to become an Iron Worker?
Are you physically and mentally able to safely perform or learn to safely perform the work of the trade, either, with or without reasonable accommodations?

YesNo
Are you able to get to and from work at various job sites anywhere within the geographical area that this apprenticeship program covers?

YesNo
Are you able and willing to attend all related classroom training as required to complete your apprenticeship?

YesNo
Are you able to climb and work from ladder, scaffolds, poles, or towers of various lengths and heights?

YesNo
Can you crawl and work in confined spaces such as attics, manholes, and crawl spaces?

YesNo
Are you able to read and understand English?

YesNo
Are you able to hear and understand verbal instructions and warnings given English?

YesNo
Have you read and understand the standard rules and regulations?

YesNo
Are you presently employed?

YesNo
If yes, do you request that we not contact your present employer?

YesNo
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.
(1) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give a job title, describe work performed and indicate reason for leaving:
(2) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(3) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(4) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(5) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(6) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(7) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(8) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(9) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
(10) Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Give job title, describe work performed and indicate reason for leaving:
Describe the work performed if so:
Did you have any part-time or summer jobs while attending school?

YesNo
References
Please provide three references with name, address, and phone number that we will be able to contact.*
Statements of Understanding
I understand all the above and state that, to the best of my knowledge, all information provided on this form is true and acurate. I hereby grant permission to all former employers and references listed to disclose any information concerning my past employment and/or qualifications. I agree that any false statement made by me in this application shall constitute grounds for disqualification of my selection, or grounds for my discharge if false information is discovered after being selected for apprenticeship.

I hereby apply for apprenticeship indenture with this sponsor and agree that if selected, I will abide by all Standards, Rules, and Policies covered by the indenture (apprenticeship agreement).
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

APPLICATION FOR APPRENTICESHIP

Education

Backround

Interest

References

Statements of Understanding