St. Paul Electrical JATC

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Application for Apprenticeship

You are applying for apprenticeship with the St. Paul Electrical JATC.

Please select the Apprenticeship you are applying for:

Residential Wireman Lineman Telecommunications

Last Name

First Name

Middle

Address

City

State

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.

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.

The name of the contractor is:

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.

Education

2. Fill in the Circle to indicate the years of formal education you have completed:

<10 10 11 12 13 14 15 16 17 18 >18

3. Are you a High School Graduate? Yes No
If NO, do you have a GED? Yes No

4. List College Degree(s) earned (Type in the boxes below):

Degree 1 (Highest Degree Earned)

Degree 2 (Second Highest Degree Earned, if any)

5. Have you received one (1) full credit of Algebra, or some higher math course, from an accredited school?

Yes No

5a. Indicate Math course(s) completed:

Yes No NJATC Tech Math

6. Have you completed any vocational/technical courses or training during or after high school?

Yes No

6a. List Courses and / or training completed:

7. Have you served in the US military? Yes No

7a. If YES, how long? In Months:

7b. Which Branch? Army Navy Air Force Marines Coast Guard Military Reserve

7c. List which military training schools you completed, if any:

8. Have you ever been convicted of a felony? Yes No

If YES, explain the conviction:

9. Do you have electrical construction work experience? Yes No

9a. If yes, how many months?

10. Do you have other construction work experience?

11. Do you have any electrical/electronic work experience?

Yes No

12. Have you applied with this apprenticeship program before? Yes No

12a. If YES, how many times?

13. Are you now, or have you ever been, a registered apprentice? Yes No

13a. If YES, list apprenticeship sponsor or employer:

13b. If YES, are you still an active apprentice in that program? Yes No

14. Do you have a valid Driver's License?

15. Do you have a Commercial Driver's License (CDL)? Yes No

15a. If YES, what class CDL do you have? A B Other

Interests and Abilities

16. List the main reason or reasons, you are applying for this apprenticeship program.

17. 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?

Yes No

18. Are you able to get to and from work at job sites anywhere within the geographical area that this apprenticeship program covers?

Yes No

19. Are you able and willing to attend all related classroom training as required to complete your apprenticeship?

Yes No

20. Are you able to climb and work from ladders, scaffolds, poles and towers of various heights?

Yes No

21. Are you able to crawl and work in confined spaces such as attics, manholes and crawlspaces?

Yes No

22. Are you able to read, hear, and understand instructions and warnings?

Yes No

23. Are you presently employed? Yes No

23a. If YES, do you request that we NOT contact your present employer at this time? Yes No

24. Did you have any part-time or summer jobs while attending school?

25. Do you have the legal right to work in the United States of America?

Yes No

Statements of Understanding

You MUST Check Each Circle for Each of the Statements (A through I) Below to Indicate Your Knowledge and Understanding. NOTE: If You Need Clarification On Any Item Do NOT Hesitate to Ask Us.

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

Yes      B. I have read and understand the basic qualifications for entry into the program.
Yes     C. 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     D. 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 E. I understand that interviews for qualified applicants will be conducted in the order in which applications are completed.
Yes F. I understand that any false information provided as part of my applications shall be just cause for denial of oral interview, or termination of my apprenticeship indenture agreement, should I be selected for the program.

Yes G. I understand that an incomplete or unsigned 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, and/or a background check before signing an indenture.

Yes I. I understand that only this ORIGINAL application form will be processed, and that Photocopies are NOT acceptable.

I have checked all the above (A thru I) 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(23a.). 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.

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

How did you become aware of this apprenticeship opportunity?

Word of Mouth Craigs List TV Career Day Posted Announcement Guidance Counselor Teacher/Instructor

Radio Newspaper Other If you checked other please tell us where:

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

St. Paul Electrical JATC
1330 Conway Street, Suite 150
St. Paul, MN 55106
(651) 772-8746 or (651) 776-4239 Ext. 5
Fax: (651)772-8786

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