Application for Apprenticeship
You are applying for apprenticeship with the St. Paul Electrical JATC.
Last Name *
First Name *
Middle
Address *
City *
State Choose oneALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY *
Zip *
Phone Number *
Social Security Number - - *
NAME CHANGE: Please provide the name that will appear on documents or transcripts that you submit, if it is different than your present name.
Last Name
First Name
Required Information Must Be Provided to Complete this Application
1. Check the Appropriate box(es) (A-F) to Indicate Your Means of Qualification for Apprenticeship.
A. I believe I can meet all minimum qualifications for apprenticeship.
B. I can produce undisputable documentation to verify that I have at least 4,000 hours of electrical construction work experience.
C. I am currently performing electrical construction work for an electrical contractor who became signatory to a union contract.
The name of the contractor is:
D. I am among the 50%, or more, who signed authorization cards while working for an electrical contractor during an organizing effort.
E. I am attempting to qualify for, and participate in, the School-to-Registered-Apprenticeship Program.
F. I am attempting to transfer into this program from another IBEW/NECA registered apprenticeship program for the same trade.
Background
2. Have you served in the US military? Yes No
2a. If YES, how long? In Months:
2b. Which Branch? Army Navy Air Force Marines Coast Guard Military Reserve
2c. List which military training schools you completed, if any:
3. Have you applied with this apprenticeship program before? Yes No
3a. If YES, how many times?
4. Are you now, or have you ever been, a registered apprentice? Yes No
4a. If YES, list apprenticeship sponsor or employer:
4b. If YES, are you still an active apprentice in that program? Yes No
5. Do you have a valid Driver's License?
Yes No
6. Do you have a Commercial Driver's License (CDL)? Yes No
6a. If YES, what class CDL do you have? A B Other
Interests and Abilities
7. List the main reason or reasons, you are applying for this apprenticeship program.
8. Are you physically and mentally able to safely perform or learn to safely perform essential functions of the job either with or without reasonable accommodations?
9. Are you able to get to and from work at job sites anywhere within the geographical area that this apprenticeship program covers?
10. Are you able and willing to attend all related classroom training as required to complete your apprenticeship?
11. Are you able to climb and work from ladders, scaffolds, poles and towers of various heights?
12. Are you able to crawl and work in confined spaces such as attics, manholes and crawlspaces?
13. Are you able to read, hear, and understand instructions and warnings?
Work History
14. Are you presently employed? Yes No
14a. If YES, do you request that we NOT contact your present employer at this time? Yes No
15. Did you have any part-time or summer jobs while attending school?
16. Do you have the legal right to work in the United States of America?
Statements of Understanding
You MUST Check Each box below (statements A through J) to acknowledge your understanding. NOTE: If you need clarification on any item, do NOT Hesitate to ask us.
Yes A. I understand that acceptance can be a long process and that completing an application does not guarantee acceptance.
Yes B. I am aware that it is my responsibility to keep this program informed of any change in my address or phone number.
Yes C. I have read and understand the basic qualifications for entry into the program.
Yes D. I understand that I must furnish certain specific documentation to provide evidence that I meet the qualifications required for entry into the pool of eligible candidates for this apprenticeship.
Yes E. I understand it is my responsibility to see that all OFFICIAL transcripts and other required documents are provided in a timely manner. If I fail to do so, my application will become null and void.
Yes F. I understand that any false information provided as part of my applications shall be just cause for cancelation of application, or termination of my apprenticeship indenture agreement, should I be selected for the program.
Yes G. I understand that an incomplete application form will NOT be processed.
Yes H. I understand that if selected for the apprenticeship program, such a selection may be conditioned by the sponsor on successfully completing additional steps, including a physical examination or other medical inquiries, drug testing before signing an indenture.
Yes I. I understand that only this ORIGINAL application form will be processed, and that Photocopies are NOT acceptable.
Yes J. I authorize the JATC to share required documentation with GAN Human Resources.
I have checked all the above (A thru J) to indicate my understanding, and state that all information provided on this form is true and accurate. I hereby grant permission to all former employers and references listed to disclose any information concerning my past employment and/or qualifications, unless I have indicated otherwise I agree that any false statements made by me on this application form shall constitute grounds for disqualification of my selection or grounds for my discharge, if false information is discovered after being selected for apprenticeship.
Type Full Name
*
I hereby apply for an apprenticeship indenture with this sponsor and agree that if selected, I will abide by all of the sponsor's Standards, Rules and Policies and the Indenture (Apprenticeship Agreement). Type in your name in the box below as your signature to these statements.
Apprenticeship Application EEOC Supplemental Information
THIS APPRENTICESHIP SPONSOR IS COMMITTED TO EQUAL OPPORTUNITY FOR ALL APPLICANTS. THE RECRUITMENT, SELECTION, EMPLOYMENT AND TRAINING OF APPRENTICES DURING THEIR APPRENTICESHIP, SHALL BE WITHOUT DISCRIMINATION BECAUSE OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, GENDER OR AGE - EXCEPT THAT THE APPLICANT MUST MEET THE MINIMUM AGE REQUIREMENT. THE JATC DOES NOT, AND WILL NOT, DISCRIMINATE BECAUSE OF THE DISABILITY OF SUCH INDIVIDUAL. WE RESPECTFULLY REQUEST THAT YOU ANSWER THESE QUESTIONS AS PART OF YOUR APPLICATION FOR APPRENTICESHIP.
PLEASE COMPLETE THE FOLLOWING
THE INFORMATION VOLUNTARILY PROVIDED BELOW IS SIMPLY FOR EQUAL EMPLOYMENT OPPORTUNITY COMMISSION (EEOC) PURPOSES. THIS INFORMATION WILL ASSIST US IN OUR EFFORTS TO PROVIDE ACCURATE INFORMATION IN COMPLIANCE WITH EEOC REGULATIONS AND REQUIREMENTS.
Race: (CHECK ONLY ONE)
American Indian or Alaskan Native Asian or Pacific Islander Black White
Ethnic Group: (CHECK ONLY ONE)
Hispanic Origin Not of Hispanic Origin
Gender
Male Female
How did you become aware of this apprenticeship opportunity?
Voluntary Disability Disclosure: (PLEASE CHECK ONE OF THE BOXES)
Yes, I have a disability (or previously had a disability)
No, I don't have a disability
I don't wish to answer