1121 Millwright Application Interest Form
750 Dorchester Ave - Boston, MA 02125 • (617) 254-1655
Disclaimer: This form is not a formal application. This form must be filled out in order to receive an invitation to our online virtual informational session to learn more about the trade and apprenticeship. At the end of the informational session, you will receive a QR code to scan and then will receive the formal apprenticeship application to fill out and submit. After the informational session and formal apprenticeship application is complete, you will be invited to an in-person interview. Please feel free to reach out with any questions to Lisa Coulter at Lcoulter@nasctf.org.
Already have 4+ years of millwright experience? Copy and paste the link below to complete a journeyperson application:
https://nasrcc-membership.carpenters.org/
Name
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First Name
Middle Name
Last Name
Preferred Name
Gender
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Male
Female
Prefer not to answer
Email Address
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Phone Number
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Format: (000) 000-0000.
Social Security Number
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Date of Birth
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-
Month
-
Day
Year
Date
Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Valid Driver's License?
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Yes
No
Are you able to obtain a security license (i.e.; base access, TWIC card, etc.)?
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Yes
No
Military Service
Are you a veteran?
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Yes
No
Education
Do you have a high school diploma or GED?
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Yes
No
If yes, graduation/completion date:
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Month
-
Day
Year
Date
Do you have college experience?
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Yes
No
Degree/Major(s):
Additional Education
Have you attended any of the following?
Apprenticeship
Welding School
Job Corps
Trade School
Vocational College
Another trade program
Did you complete the program?
Yes
No
If yes, name and location of school(s):
Number of Weeks/Months/Years completed:
Courses/Trades studied:
Have you ever been expelled from an apprenticeship program?
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Yes
No
If yes, what program and why?
Have you ever been a member of the United Brotherhood of Carpenters (UBC)?
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Yes
No
Additional Information
Working in the trades requires hard physical labor, repetitively lifting over 50 pounds, working in confined spaces, remote sites, climbing, working at heights, long hours, and frequent exposure to elements.
Are you physically and mentally able to learn and safely perform the work of this trade, either with or without reasonable accommodation?
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Yes
No
Are you able and willing to attend all related classroom instruction as required?
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Yes
No
Why are you interested in applying for Membership?
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List any trade skills, knowledge, certifications, etc., that you may have related to this trade:
Employment History
Employer
*
Start Date
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-
Month
-
Day
Year
Date
Contact Person
*
Phone Number
*
Format: (000) 000-0000.
Work/Duties Performed
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Reason for Leaving
*
Employer
Start Date
-
Month
-
Day
Year
Date
Contact Person
Phone Number
Format: (000) 000-0000.
Work/Duties Performed
Reason for Leaving
Employer
Start Date
-
Month
-
Day
Year
Date
Contact Person
Phone Number
Format: (000) 000-0000.
Work/Duties Performed
Reason for Leaving
Application EEOC Supplemental Information Form
Millwright Local 1121 is committed to equal opportunity for all applicants. The recruitment, selection, employment, and training of apprentices during their apprenticeship, shall be without discrimination because of race, color, religion, national origin, sex, or age - except the applicant must be 18 years of age. The information, voluntarily provided below, is simply for equal employment opportunity commission (EEOC) purposes. The information will assist us in our efforts to provide accurate information in compliance with EEOC regulations and requirements.
Race
Alaska Native/ American Indian
Asian
Hawaiian/ Pacific Islander
African American/ Black
Caucasian
Are you of Hispanic or Latino heritage?
Yes
No
How did you hear about us?
*
Resume
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Disclaimer and Signature
I certify that all of the statements and information given now or hereafter given by me, in support of my application for apprenticeship, is true and complete to the best of my knowledge. I understand that any false or misleading information will disqualify me from consideration for Membership/ Apprenticeship or subject me to immediate dismissal from the apprenticeship program at any time throughout my apprenticeship. I authorize Millwright Local 1121 to verify any of the information given, during the application process, with appropriate individuals, companies, organizations, or agencies and I authorize them to release such information as required, including my prior disciplinary record and drug test results, without any obligation to give me written notice of disclosure. I hereby release the Millwright local 1121 from any liability whatsoever as a result of such inquiries and disclosures. A photocopy of or other electronic reproduction of this authorization is binding and may be relied upon. I acknowledge that I have read, understood, and accepted the above statement in its entirety, and have had the opportunity to ask questions regarding any aspect of this application and that I accept the above terms.
Signature
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Date
*
-
Month
-
Day
Year
Date
Apply
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