APPRENTICESHIP APPLICATION 

BRICKLAYERS AND ALLIED CRAFTWORKERS

LOCAL NO. 3 IOWA

2425 Delaware Avenue

Des Moines, Iowa  50317

Phone:  515/262-7445

No. ___________________

Date: ________________________________________________________________________

Name: ________________________________________________________________________

Position: Bricklayer Apprentice

Area / Chapter: _________________________________________________________________

QUALIFICATION REQUIREMENTS

  1. Must be at least 18 years of age;
  2. Must provide proof of educational attainments such as high school and/or college transcripts, or official reports of results on the General Education Development (G.E.D.) tests;
  3. Must be able to satisfactorily complete the apprenticeship, including classroom instruction;
  4. Must be physically able to perform the work of the trade. Before employment, all applicants conditionally accepted for probationary apprenticeship will be required to pass a physical examination, including drug testing as prescribed by the local Joint Apprenticeship and Training Committee;
  5. Must provide military transfer or discharge Form DD-214, if applicable;
  6. Must appear for an interview when notified.

REQUIREMENTS UPON APPRENTICESHIP ACCEPTANCE
  1. Serve as a probationary apprentice for a period of 3 months;
  2. Serve a 4 year apprenticeship, including the probationary period;
  3. Report for work on a regular basis;
  4. Provide your own transportation to and from the job site;
  5. Work under the direction of a Journeyman on the job site and perform duties satisfactorily;
  6. Attend related training classes regularly and maintain an acceptable average in those classes;
  7. Will be required to purchase necessary hand tools;
  8. Abide by all rules and regulations of the Joint Apprenticeship and Training Committee (JATC).

 

I, the undersigned, have read, understood and agree to abide by the above.

 

 

Signed: ______________________________________ Date: ____________________

 

IMPORTANT

PLEASE NOTE THAT THIS FORM NEEDS TO BE PHYSICALLY TURNED IN AT THE UNION HALL -

CANNOT BE MAILED, FAXED OR E-MAILED. 

BRICKLAYERS AND ALLIED CRAFTWORKERS

LOCAL NO. 3 IOWA

2425 Delaware Avenue

Des Moines, Iowa  50317

Phone:  515/262-7445

 

 

 

 

 

 

Personal History

Name: ______________________________________________________________

Are you 18 years of age: _____                          Yes ___      No ___

Address: Street:__________________________________________________

City, State, Zip Code: __________________________________________________

County: _____________________________________________________________

Social Security No.: ___________________________________________________

Phone: _____________________________________________________________

Educational History

Name of High School: _________________________________________________

Date Graduated: ________________ Date G.E.D. completed: _______________

Name of College or Technical School: ____________________________________

Program of area or study: ______________________________________________

Date completed program: ______________________________________________

Work History

Veteran? ___ Branch of Service ___ Length of Service ___ Type of Discharge ___

Are you currently employed?          Yes _____ No _____

List jobs in order, start with present or latest job. Include summer and part-time jobs also any military experience.

Employer and Address Type of Work                                   From/To Reason For Leaving

 

 

 

 

________________________________________________________________________________________________________________________________________________________________________________________________

The statements and answers shown above are complete and true to the best of my knowledge.

Signed: __________________________________Date: __________________

 

Affirmative Action Data Record

Employees are treated during employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

As an employer with an Affirmative Action Program, we comply with government regulations, including Affirmative Action responsibilities where they apply.

The purpose for this Data Record is to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of this Data Record is optional. If you choose to volunteer the requested information, please note that all Data Records are kept in a Confidential File and are not a part of your Application for Employment or personnel file. Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

(Please Print)

Last Name                           First Name                                          Middle Name

 

Address Number              Street                     City                   State              Zip

 

Telephone Number(s)                                      Social Security Number

 

 

REFERRAL SOURCE:

___Advertisement      ___Employee            ___Relative        ___Private Employment Agency

___Friend     ___Walk-in    ___Government Employment Agency ___Other____________

 

Complete Only The Sections Below That Have Been Checked

Current Job:
      Circle One:                Male                Female
  • Circle One Of The Following (Ethnic Origin)

          White           Hispanic              American Indian / Alaskan Native

          Black           Other                   Asian / Pacific Islander

 
  • Circle If Any Of The Following Are Applicable

         Vietnam Era Veteran            Disabled Veteran           Disabled Individual

Birthdate: