APPLY 2

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: Hold control key as you select all choices

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

A.Gender

B. Ethnic or Race Derivation(CHECK ONLY ONE)(Read Previous Instructions)