IN-PERSON APPLICATION FOR ELECTRICAL WORKERS

IN-PERSON APPLICATION FOR ELECTRICAL WORKERS

International Brotherhood of Electrical WorkersLocal Union 553 / Raleigh-Durham, N.C. / AFL-CIOUnion Office: Phone (919) 596-8220 • Fax (919) 596-6657
Personal Information
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Home/Work Phone*

Area CodePhone Number
Email*
example@example.com
Residence Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Basic Requirements
Number of years working in electrical industry:
Did you serve an Apprenticeship?*
Number of years attended Apprenticeship:
Completion certificate?*
Sponsoring Company:
Location of Apprenticeship School:
Have you started the intake process with an IBEW JATC (Joint Apprenticeship and Training Committee)??*
If yes, list the JATC location and the name of the director or coordinator you have been in contact with:
Director name and City
Have you ever passed an examination given by an IBEW Local Union?*
Have you ever been certified or possessed a Journeyman Electrician license?*
Phases of Electrical Installations Performed (check all that apply)
Conduit Bending & Installation*

RigidEMTPVCHydraulicNone
Residential Wiring*

Single HousingCondosApartmentsHigh RisesHotelsNone
Please indicate if you have any of the following skills or training*

TransformersSubstationsCable SplicingElectronic ControlsPLC’sHMI’sConcrete Slab InstallationCommercial LightingUnderground DistributionIndustrial WiringOverhead Line WorkMaintenance & TroubleshootingTilt-UpsPhotovoltaicsControl WiringVDVAlarm SystemsSupervisionNoneOther
Do you have a valid state driver’s license?*
Are you currently employed by an electrical contractor?*
Are you willing to travel for work within Local 553’s jurisdiction (Raleigh–Durham and surrounding counties) and, if needed, outside North Carolina?*
EDUCATION AND WORK HISTORY
High School*
High School Name
Graduated High School?*

YesNo
High School City and State:

CityState
College
College Name
Graduated College?

YesNo
Trade School
Trade School Name
Graduated Trade School?

YesNo
List four (4) employers, starting with current or most recent:
Employer 1:
Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment:
Start and end Date
Wage Rate:
Hourly Rate
Type of Work:
Employer 2:
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment:
Start and end Date
Wage Rate:
Hourly Rate
Type of Work:
Employer 3:
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment:
Start and end Date
Wage Rate:
Hourly Rate
Type of Work:
Employer 4:
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment:
Start and end Date
Wage Rate:
Hourly Rate
Type of Work:
Please select your availability for the given days and time phases*

Monday - DaysMonday - NightsTuesday - DaysTuesday - NightsWednesday - DaysWednesday - NightsThursday - DaysThursday - NightsFriday - DaysFriday - NightsSaturday - DaysSaturday - NightsSunday - DaysSunday - Nights
Other times available.
Additional Comments
Applicant Statement
Date

MonthDayYear
Date
By signing this application, I affirm that all statements made by me herein are true, complete, and correct to the best of my knowledge and belief, and are made in good faith to assist in determining my proper classification or group within Local IBEW 553. I understand that any false statements may result in rejection of this application, denial of a referral, or, if I am referred and employed, discharge from a job.
Signature
Should be Empty:

IN-PERSON APPLICATION FOR ELECTRICAL WORKERS

Personal Information

Basic Requirements

Phases of Electrical Installations Performed (check all that apply)

EDUCATION AND WORK HISTORY

List four (4) employers, starting with current or most recent:

Applicant Statement