North Alabama Electrical Training Alliance Apprenticeship Application FormContact InformationFull Legal NamePast NameEmailPhoneStreet AddressCityCountyStateZip CodeSocial Security NumberApprenticeship QualificationsSelect all that Apply to Indicate Your Means of Apprenticeship Qualification I believe I can meet all minimum qualifications for apprenticeship. I can produce undisputable documentation to verify that I have at least 4,000 hours of electrical construction work experience. I am currently performing electrical construction work for an electrical contractor who became signatory to a union contract. 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:EducationYears of Education Completed- Select -Less than 10101112131415161718 or moreAre you a high school graduate? Yes NoDo you have a GED? Yes NoDo you have a college degree? Yes NoHighest Degree EarnedMajor(s)SchoolHave you received at least one (1) full credit for Algebra, or some higher math course, from an accredited school? Yes NoCompleted Math Courses Algebra I Algebra II Geometry Trigonometry Calculus NJATC Tech MathHave you completed any vocational/technical courses or training during or after high school? Yes NoList courses and/or training you have completed.BackgroundHave you served in the U.S. military? Yes NoHow long did you serve in the military (in months)?Which branch? Army Navy Air Force Marines Coast Guard Military ReserveList which military training schools you completed, if any.Have you ever been convicted of a felony? (Conviction will not automatically disqualify you). Yes NoPlease explain the conviction.Do you have electrical construction work experience? Yes NoHow many months of electrical construction work experience?Do you have other construction work experience? Yes NoDo you have any electrical/electronic work experience? Yes NoHave you applied with this apprenticeship program before? Yes NoHow many times?Are you now, or have you ever been, a registered apprentice? Yes NoProvide your apprenticeship sponsor or employer.Are you still an active apprentice in that program? Yes NoDo you have a valid driver's license? Yes NoDo you have a valid Commercial Driver's License (CDL)? Yes NoWhat class CDL do you have?Interests & AbilitiesList the main reason(s) you are applying for this apprenticeship program.Are you physically and mentally able to safely perform or learn to safely perform essential functions of the job with or without reasonable accomodations? Yes NoAre you able to get to and from work at job sites anywhere within the geographical area that this apprenticeship program covers? Yes NoAre you able and willing to attend all classroom training as required to complete your apprenticeship? Yes NoAre you able to climb and work from ladders, scaffolds, poles, and towers of various heights? Yes NoAre you able to crawl and work in confined spaces such as attics, manholes, and crawlspaces? Yes NoAre you able to read, hear, and understand instructions and warnings? Yes NoWork HistoryAre you presently employed? Yes NoDo you request that we NOT contact your present employer at this time? Please do not contact. Please feel free to contact.Did you have any part-time or summer jobs while attending school? Yes NoDo you have the legal right to work in the United States of America? Yes NoEmployment HistoryFor the past four years.Employment #1Company NameStart DateEnd DateBrief Job DescriptionReason for LeavingEmployment #2Company NameStart DateEnd DateBrief Job DescriptionReason for LeavingEmployment #3Company NameStart DateEnd DateBrief Job DescriptionReason for LeavingEmployment #4Company NameStart DateEnd DateBrief Job DescriptionReason for LeavingEmployment #5Company NameStart DateEnd DateBrief Job DescriptionReason for LeavingApprenticeship Application EEOC Supplemental InformationThis 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 an individual. 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.Ethnic Group Hispanic Origin Not of Hispanic OriginRace American Indian or Alaskan Native Asian or Pacific Islander Black WhiteGender Male FemaleHow did you become aware of this apprenticeship opportunity? Word-of-Mouth TV Career Day Posted Announcement Guidance Counselor Teacher/Instructor Outreach Organization Radio Newspaper OtherName of NewspaperOtherStatements of UnderstandingI UnderstandA. It is my responsibility to keep this program informed of any change in my address or phone number.B. I have read and understand the basic qualifications for entry into the program.C. 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.D. 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.E. Interviews for qualified applicants will be conducted in the order in which applications are completed.F. Any false information provided as part of my application shall be just cause for denial of oral interview, or termination of my apprenticeship indenture agreement, should I be selected for the program.G. An incomplete or unsigned application form will NOT be processed.H. 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.I. Only this original application form will be processed, and that photocopies are not accepted.I have read through and selected all of the above ( A through 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 information concerning my past employment and/or qualifications unless I 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. 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).Your NameToday's DateApplication FeePrice: $25.00Pay with Card (Stripe)Submit
