CM 404 Apprentice Application

Education (All Schools Above Elementary)
Name and Location of School*
From (Year)*
To (Year)*
Degree earned*
Name and Location of School
From (Year)
To (Year)
Degree earned
Name and Location of School
From (Year)
To (Year)
Degree earned
Name and Location of School
From (Year)
To (Year)
Degree earned
Work Experience

Last three occupations - list most recent employer first
Employer Name*
Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From*
To*
Immediate Supervisor*
Type of Work*
Employer Name
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From
To
Immediate Supervisor
Type of Work
Employer Name
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
From
To
Immediate Supervisor
Type of Work

References: List (3) Relatives
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to you*
Age*
Occupation*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to you*
Age*
Occupation*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to you*
Age*
Occupation*
List Three (3) Persons, NOT Relatives Or Employers, With Whom You Are Well Acquainted
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years known*
Occupation*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years known*
Occupation*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years known*
Occupation*

Have You Ever Been Convicted Or Pled No Contest For Any Violation Of Any Federal, State, Or Municipal Law Or Ordinance?
YesNo
Conviction*
Date*

MonthDayYear
Date
Place where convicted or pled no contest*
Conviction
Date

MonthDayYear
Date
Place where convicted or pled no contest
Conviction
Date

MonthDayYear
Date
Place where convicted or pled no contest
YesNo
Please upload a valid drivers license for our files *

Cancelof
Please describe your reason for choosing the cement mason trade*
Certification

I have read all of the above questions. I certify that the information furnished in answer to this questions is correct and complete to the best of my knowledge and belief, and I understand that it is of great importance in the consideration of my eligibility for apprenticeship. I make this statement to the Joint Apprenticeship Committee with the understanding that it will be used by the committee is carrying out its duty in selecting pre-apprenticeship and apprenticeship applicants. I further understand that any false statement or omission of material fact may be sufficient cause for rejection of my application, or dismissal after my indenture or employment.
Applicant Signature*

Clear
Parent or Guardian Signature (if a minor)

Clear
Release

I hereby release all previous employers, references or other persons from any and all liability and damage of whatsoever nature on account of furnishing information requested which is to be used in determining my fitness for an apprenticeship in the cement masons apprenticeship program.
Signature*

Clear
Where did you learn about the Cement Masons Local 404 Joint Apprenticeship Program?
If it was in a notice or ad in a newspaper, which paper(s)?
Notice

All applicants will be sent a letter with notification of testing date in MARCH. You must present a valid drivers license at the testing site or you will not be tested.

In addition, you will need to bring a copy of your highschool diploma, graduation transcript, or G.E.D. Certificate
Please verify that you are human*
Should be Empty:

Pre-Apprenticeship & Apprenticeship Application

Personal Information

Marital & Citizenship Information

Military Service

Education (All Schools Above Elementary)

Work Experience

References: List (3) Relatives

List Three (3) Persons, NOT Relatives Or Employers, With Whom You Are Well Acquainted

Have You Ever Been Convicted Or Pled No Contest For Any Violation Of Any Federal, State, Or Municipal Law Or Ordinance?

Certification

Release

Notice