• APPLICATION FOR APPRENTICESHIP

  • THIS FORM HAS BEEN APPROVED BY THE UNITED STATES DEPARTMENT OF LABOR - BUREAU OF APPRENTICESHIP AND TRAINING
    YOU MUST PRINT ALL INFORMATION AND MAKE NO STRAY MARKS ON THIS FORM
    THIS FORM MUST BE COMPLETED IN ITS ENTIRETY BY THE APPLICANT

  • APPLICANT'S INFORMATION

  • Format: (000) 000-0000.
  • Is this a cell number?*

  • MAILING ADDRESS

  • EDUCATION

  • 2. Are you a high school graduate?*
  • Do you have a GED?*
  • Do you have any of the following? (Check all that apply)*
  • 3. Did you ever participate in any kind of masonry training during or after high school?*
  • 4. Did you ever participate in any kind of school-to-work (co-op education) program when you were in school?*
  • 4b. Did you obtain full time employment (placement) in a related field upon completion of the program?*

  • BACKGROUND

  • 5. Have you served in the U.S. military?*
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  • 6. Do you have masonry construction work experience?*
  • 7. Do you have experience in any kind of construction work?*
  • 8. Have you applied with this apprenticeship program before?*
  • 9. Have you applied for apprenticeship in any other trade or occupation?*
  • 10. Have you participated in an apprenticeship of any kind?*
  • 11. Are you currently serving an apprenticeship?*
  • 12. Do you have a valid driver's license?*
  • 12a. Did you ever have a driver's license?*

  • INTEREST

  • 13. How did you learn about this program?*

  • ABILITY

  • 16. Are you physically and mentally able to safely perform or learn to safely perform the work of this trade, either with or without reasonable accommodations?*
  • 17. Are you able to get to and from work at various job sites anywhere within Oregon and Southwestern Washington?*
  • 18. Are you able and willing to attend all related classroom training as required to complete your apprenticeship?*
  • 19. Are you able to climb and work from ladders, scaffolds of various lengths and heights?*
  • 20. Can you crawl and work in confined spaces?*
  • 21. Are you able to read and understand English?*
  • 22. Are you able to hear and understand verbal instructions and warnings given in English?*

  • WORK HISTORY

  • 23. Are you presently employed?*
  • 23a. Do you request that we DO NOT contact your employer?*
  • 24. Do you have previous work history to enter?*
    • Employer  

    • LIST ALL EMPLOYERS, BEGIN WITH YOUR PRESENT OR MOST RECENT EMPLOYER. PROVIDE DATES (FROM AND TO) TO SHOW HOW LONG YOU WERE EMPLOYED WITH EACH EMPLOYER.

    • Full or Part Time?*
    • Do you want to add another employer?*
    • Employer 2  
    • Full or Part Time?*
    • Do you want to add another employer?*
    • Employer 3  
    • Full or Part Time?*
    • Do you want to add another employer?*
    • Employer 4 
    • Full or Part Time?*

    • NOTE: If you need to add additional work history information, please include the information on a separate document and attach it below.

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    • End of Work History 
    • 25. Did you have any part-time or summer jobs while attending school?*
    • 26. Do you have the necessary documents, as required by INS regulations to prove that you have the legal right to work in the United States of America?*

  • STATEMENT OF UNDERSTANDING

  • You must initial AFTER each of the statements (A through M) below to indicate your knowledge and understanding.

    NOTE:  IF YOU NEED CLARIFICATION ON ANY ITEM BELOW BEFORE INITIALIZING IT, DO NOT HESITATE TO ASK.

  • A. I am aware that it is my responsibility to keep this program informed of any change in my address or phone number. *

    B. I have read and understand the basic qualifications for entry into this program. *

    C. I have been given specific instructions as to what is required of me to complete this application and to become qualified for oral interview.   *   

    D. I understand that I must furnish documentation to provide evidence that I do meet the required qualifications for entry into the pool of eligible candidates for this apprenticeship.   *   

    E. I understand that it is my responsibility to see that all transcripts and other required documents are provided in a timely manner in order to complete my application.   *   

    F. I understand that if I fail to submit ALL of the required information within the specified time frame, my application may be considered incomplete. *   

    G. I understand that I cannot qualify for interview until I have met the minimum basic qualifications and have provided the necessary transcripts and documents as required.   *   

    H. I hereby acknowledge that I bear the sole responsibly for completing my application following the instructions provided.   *   

    I. I understand that interviews for qualified applicants will be conducted in the order in which the  applications are completed.   *   

    J. I understand that any intentional false statement of information I have provided on this application form or on other documents shall be cause for denial of oral interview or termination of indenture, should I be selected for the program.   *   

    K. I understand that an incomplete or unsigned application form will NOT be processed.   *   

    L. I understand that if selected, I will be required to complete the selection process by qualifying on any examination, including a physical examination or drug testing, as required by the sponsor, either before or after signing an indenture.   *   

    M. I understand that only the ORIGINAL application form will be processed; photocopies are NOT acceptable.   *   

  • Understanding all the above and stating that, to the best of my knowledge, all information provided on this form is true and accurate; I hereby apply for an apprenticeship indenture with this sponsor and agree that if selected; I will abide by all Standards, Rules and Policies covered by the indenture (apprenticeship agreement

    In submitting this application, I authorize investigation of all statements contained in it, and it is understood and agreed that any misrepresentation by me in this application may result in cancellation of the application and/or separation from the apprenticeship program for which I have applied.

    I authorize any person, school, current employer, past employer(s), and organizations named in my application for this apprenticeship program to provide the JATC Training Coordinator with relevant information and opinion that may be useful in making a decision to accept me into the apprenticeship program, and I release such persons and organizations from any legal liability in making such statements.

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  • DATE
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