IUPAT DC57 APPRENTICESHIP APPLICATION
Section I:
Name
*
First Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
Date
Social Security Number
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PA Driver's License?
*
Please Select
A-Class
B-Class
C-Class
None
Do you have transportation?
*
Yes
No
Field of Study in High School
*
Highest level of Education
*
Certificates or Licenses if any
Special skill or knowledge pertaining to the craft you are applying to
How did you hear about IUPAT DC57?
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Work History
Begin with the most recent. If available, please attach your resume in Section V of this form.
Most Recent Employer
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment Start Date
-
Month
-
Day
Year
Start Date
Employment End Date
-
Month
-
Day
Year
End Date
Job Title
Duties
Hours a week worked
Previous Employers
Previous Employer #1
Previous Employer #1
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment Start Date
-
Month
-
Day
Year
Start Date
Employment End Date
-
Month
-
Day
Year
End Date
Job Title
Duties
Hours a week worked
Previous Employer #2
Previous Employer #2
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment Start Date
-
Month
-
Day
Year
Start Date
Employment End Date
-
Month
-
Day
Year
End Date
Job Title
Duties
Hours a week worked
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Section Il:
(This section is optional. The information in this section is complied for statistical purposes only)
Gender
Please Select
Male
Female
Other
Gender (self-describe)
*Are you a veteran?
Yes
No
Race/Ethnic Group (Select one or all that apply)
White (Non Hispanic)
Black (Non Hispanic)
Hispanic
American Indian or Alaskan Native
Asian or Pacific Islander
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Section Ill:
Type of Apprenticeship applying for (select one)
*
Please Select
Drywall 3 year program
Commercial Painter 3 year program
Glazier 4 year program
Industrial Painter 3 year program
If selected I am willing to:
Serve an apprenticeship of "X" number of years.
*
Please Select
1 Year
2 Year
3 Year
4 Year
Serve a probationary period for 1,000 work hours.
*
Yes
No
Work for the established wage scale of District Council #57 throughout my apprenticeship.
*
Yes
No
Obey all rules and instructions of the apprenticeship committee.
*
Yes
No
Attend all mandatory classes during the hours designated by the apprenticeship committee.
*
Yes
No
To be accountable to FTI during the apprenticeship term.
*
Yes
No
To undergo a physical examination.
*
Yes
No
To travel if needed.
*
Yes
No
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Section IV:
List Three personal references other than relatives.
Name #1
*
Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name #2
*
Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name #3
*
Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Section V:
Please upload your required documents.
Driver's License
*
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High School Diploma or Equivalent
*
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Resume
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Signature
I certify that the information on this application is accurate to the best of my knowledge.
Signature
Date
*
/
Month
/
Day
Year
Date
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