APPLICATION

Apprenticeship Application

First name:*
Middle name:
Last name:*
Date of birth:*
SSN:*
Drivers license number:*
Region:*
Veteran:
Street:*
City:*
State:*
Zip code:*
Primary phone number:
Secondary phone number:
Email:*

Choose What type of apprenticeship you are applying for? (PICK ONE)*

Choose ALL AREAS THAT YOU ARE WILLING TO WORK *

Instructions: To select multiple locations on a desktop, hold control key while making selection. To select multiple locations on mobile, tap one or more locations.

You Must keep the Apprenticehip Training office advised of any mailing address or phone changes

How did you first hear about the Sheet Metal workers Apprenticeship Training Program? Please Select one*

If you picked other as a response on the previous question please tell us what Other is

Are you Currently a Local 104 member*

If you picked yes on the previous question what classification of membership do you currently hold

Have you ever been a Local 104 member*

If you picked yes on the previous question what year(S) were you a member?

Are you 18 years of age or older? If you are under 18, parent or guardian will be required to come to the training center to sign a consent form*

Would you be willing to work as a Pre- Apprentice?*

You must be physically able to perform the work of the trade as indicated in the Essential Functions Job Analysis. Have you read the Essential Functions Job Analysis?*

Applicant Signature:*
Instructions By typing your Name in the required field on the following question you are stating all information entered is correct and truthful

Application Date: *
Instructions: Enter the date in the following question as MM/DD/YYYY Example 01/01/2001

GENDER & ETHNIC DATA

To be in compliance with the Civil Rights Act of 1964 and other regulations referenced below, this Joint Apprenticeship and Training Committee is required from time to time to compile reports that include data on the gender and ethnic background of all applicants. Please VOLUNTARILY check the appropriate boxes designating your gender and ethnicity.

A.Gender

B. Ethnic or Race Derivation(CHECK ONLY ONE)
Instructions: IF picking Asian or Pacific Islander in the following question Please be specific from list following Asian or Pacific Islander.