UA 149 Journeyman Application

Journeyman Application
The following will be required if you are accepted:
1. Work Resume
2. Valid Driver’s License
3. Birth Certificate
4. Social Security Card
5. OSHA 10 Card
6. All Trade School and Other Certificates
7. All Current Licenses
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Email*
Phone Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position Desired*
Education/Skill
Name of High School*
Graduated:*
How many years completed?*
Name of College*
Major Course of Studies
Graduated:*
How many years completed?*
Trade/ Tech School:*
Graduated:*
How many years completed?*
Other Courses/ Schooling
Employment History & Background

Your background and work history will be discussed with you during your interview. Please answer all questions prior to the interview.
- Name of Company
- Employment Dates
  To & From
- Position Held
- Rate of Pay
- Reason for Leaving
- Name of Company
- Employment Dates
  To & From
- Position Held
- Rate of Pay
- Reason for Leaving
- Name of Company
- Employment Dates
  To & From
- Position Held
- Rate of Pay
- Reason for Leaving
- Name of Company
- Employment Dates
  To & From
- Position Held
- Rate of Pay
- Reason for Leaving
- Have you ever been placed on probation or terminated for poor job performance?
- Have you ever been disciplined or discharged for violating a safety rule?
- Have you ever been disciplined or fired for insubordination?
- Have you ever been disciplined or terminated for absenteeism, tardiness, failure to notify your company when absent or any other attendance related reason?
- Have you ever been disciplined or fired for fighting, assault, or similar offenses?
- Have you ever been disciplined or discharged for being under the influence of alcohol or drugs, or for possession, use or abuse of alcohol, drugs or firearms?
- PlumberPipefitterWelderResidentialHVAC
- Med Gas/BrazeMed Gas/NFPAConfined Space EntryCFC- Refrigeration RecoveryValve Tech (Practical)DetailerRiggerCleanroomSpeedbendingForeman (UA Course)Steward (UA Course)AWS/CWIMachiningFlame CuttingTube BendingLayout & OffsetCopper FittingVictraulicHeavy WallTWICS
- UA 01UA 02UA 03UA 015UA 18AUA 21UA 22UA 23UA 41UA 42UA 43
- STAR PlumberSTAR PipefitterSTAR HVAC
- OSHA 10 (Required)OSHA 30OSHA 500
- If you are accepted for a probationary period, you will be required to:
  1. Report to work on a daily basis
  2. Provide for your transportation to and from the job site
  3. Work under the direction of a journeyman on the job site and perform job duties
  4. Attend related training classes regularly and maintain an acceptable average in those classes
  5. Purchase text material for use in related training classes as required
  You will be subject to a drug test after your interview.
- Should be Empty:

Journeyman Application

Education/Skill

Employment History & Background