ONLINE APPLICATION

We invite you to complete our online application to get started today.

FROM: Joint Apprenticeship and Training Committee
For the Electrical Contracting Industry
142 Corporate Drive, Binghamton, NY 13904

"*" indicates required fields

Step 1 of 11 - EQUAL OPPORTUNITY

EQUAL OPPORTUNITY -

WE ARE AN EQUAL OPPORTUNITY EMPLOYMENT UNION.

We are dedicated to strict policy on non-discrimination in employment on any basial including: race, creed, color, age, sex, religion, national origin, disability, marital status, military status, or arrest record.

SUPPLEMENTAL INFORMATION FORM

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 against a qualified individual with a disability because of the disability of such individual. We respectfully request that you complete this form along with your completed application form for apprenticeship.

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:

American Indian or Alaskan Native

Alaskan or Pacific Islander

Black

White

Gender:

Male

Female

Ethnic Origin

Hispanic

Not of Hispanic Origin

How did you become aware of this apprenticeship opportunity?

Word of Mouth

Career Day

Posted Announcement

Guidance Counselor

Teacher / Instructor

Outreach Organization

Radio

Newspaper

Other

If newspaper, name of paper:

If other, explain:

PRE-QUALIFICATION

Are you at least 17 years of age to apply and 18 years of age at time of indenture?*

Yes

I have a:*

High School Diploma

GED/HSE

Neither

Did you satisfactorily complete and receive credit for Algebra 1 (or some other higher math) in high school or in a post HS institution?*

Yes

Do you have a valid NYS Driver’s License?*

Yes

Have you been a resident in our jurisdiction for at least the last six months?*

Yes

FIND YOUR COUNTY FOR ANSWER WHICH FOLLOWS:

BROOME – Entire County – all Townships

CHENANGO - Townships of Afton, Bainbridge, Coventry, German, Greene, Guilford, Lincklaen, McDonough, North Norwich, Norwich, Otselic, Oxford, Pharslia, Pitcher, Plymouth, Preston, Smithville and Smyrna

DELAWARE - Townships of Davenport, Delhi, Deposit, Franklin, Hamden, Masonville, Meredith, Sidney, Tompkins, Walton, and that portion of Colchester and Hancock north of the East Branch of the Delaware River

OTSEGO - Townships of Butternuts, Harwick, Laurens, Maryland, Milford, Morris, Oneonta, Otego, Unadilla and Westford

TIOGA - Township of Berkshire, Newark Valley, Owego, Richford and Tioga

If a resident, which county?

STOP!

If you answered "NO" to any of the questions above, DO NOT PROCEED. In order to meet pre-qualification requirements, you must answer "YES" to each of the above questions. Press "Continue" only if you answered "YES" to all questions. Thank you!

PERSONAL DATA

First Name*

First

Middle Name

Middle

Last Name*

Last

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Alternative Phone

NAME CHANGE

Alternative First Name

Alternative Last Name

QUALIFICATION

Mark the appropriate statement(s) below to indicate how you qualify for interview and/or evaluation for acceptance into this Electrical Apprenticeship Program.

Qualification

I qualify for the interview because I meet all minimum qualiifications for apprenticeship.

I am attempting to qualify for interview based on previous work experience.

I qualify for evaluation and entry into apprenticeship because I am transferring apprenticeship from another IBEW/NECA program.

If either of the (above) two items are checked, list Contractor's Name

I qualify for evaluation and entry into apprenticeship because I am transferring apprenticeship from another IBEW/NECA program.

If either of the (above two items are checked, list Contractor's Name

Other

qualify for evaluation

I qualify for evaluation and entry into apprenticeshiip because I was among the 50% who signed authorization cards while I was working for a contractor who did not become a signatory.

EDUCATION

Select the highest level of education you have completed.*

List college degree (s) earned

Degree 1

Major 1

School 1

Degree 2

Major 2

School 2

Degree 3

School 3

Major 3

Did you ever participate in any kind of vocational technical training during or after High School?*

Yes

If yes, how many months long was the program?

Please describe the program

Did you complete the program?

Yes

Did you participate in any kind of school-to-work (co-op education) while you were in high school?*

Yes

If yes, describe the program

Did you obtain full time employment (placement) in a related field upon completion of the program?

Yes

BACKGROUND

Have you served in the U.S. military?*

Yes

If yes, how many months?

If yes, which branch

List any completed military training schools

FELONY CONVICTION

Have you ever been convicted of a felony? (conviction will not automatically disqualify you).*

Yes

If yes, explain the conviction

CONSTRUCTION EXPERIENCE

Do you have electrical construction work experience?*

Yes

Do you have other construction work experience?*

Yes

APPRENTICE EXPERIENCE

Have you applied with this apprenticeship program before?*

Yes

If yes, which years?

If yes, how many times?

Have you applied for apprenticeship in any other trade or organization?*

Yes

Have you participated in an Apprenticeship of any kind?*

Yes

If yes, what discipline?

Are you currently serving an Apprenticeship?*

Yes

If yes, list the employer or apprenticeship sponsor:

DRIVERS LICENSE

Do you have a drivers license?*

Yes

Do you have a commercial Drivers License (CDL)?

Yes

INTERESTS & ABILITIES

List the reasons you are applying for this apprenticeship program:*

Give a brief description of the kind of work you think is involved with this trade:*

Are you physically and mentally able to safely perform or learn to safely perform the work of this trade, either with or without reasonable accomodations?*

Yes

Are you able to get to and from work at various job sites anywhere within the geographic area that this apprenticeship program covers?*

Yes

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

Yes

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

Yes

Can you crawl and work in confined spaces such as attics, manholes and crawlspaces?*

Yes

Are you able to read and understand English?*

Yes

WORK HISTORY (part a)

Are you presently employed?

Yes

If yes, may we contact your work employer now?

Yes

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

Yes

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

Yes

WORK HISTORY (part b)

Employer #1
Please fill in the following "required" information...

Employer 1

Address 1

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Started Work

Ended Work

Description of Work

Ended Work

Reason for Leaving

Employer #2

Please fill in the following information

Employer 2

Address 2

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Started Work

Ended Work

Description of Work

Reason for Leaving

Employer #3

Please fill in the following information

Employer 3

Address 3

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Started Work

Ended Work

Description of Work

Reason for Leaving

Employer #4

Please fill in the following information

Employer 4

Address 4

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Started Work

Ended Work

Description of Work

Reason for Leaving

APPRENTICESHIP APPLICATION EEOC SUPPLEMENTAL INFORMATION Equal Opportunity Employer

The 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.

PLEASE FILL IN THE FOLLOWING

How did you become aware of this apprenticeship opportunity (check all that apply)?*

Word of Mouth

Career Day

Posted Announcement

Guidance Counselor

Teacher/Instructor

Outreach Organization

Radio

Newspaper

Other

If Newspaper was checked above, please provide the name of the paper.

If other was checked above, please provide the source.

NOTE

The questions in this section will not become part of your personnel file. It will be maintained in a separate file, used only for EEOC Reporting Purposes.

STATEMENT OF UNDERSTANDING

You must mark each statement below to indicate your knowledge and understanding. If you need clarification on any item, do not hesitate to ask.

I am aware that it is my responsibility to keep this program informed of any change in my address or any contact information.

I have read and understand the basic qualifications for entry into the program.

I have been given specific instructions as to what is required of me to complete this application and to become qualified for oral interview.

I understand that I must furnish documentation to provide evidence that I do meet the qualifications required for entry into the pool of eligible candidates for this apprenticeship.

I understand that it is my responsibility to see that all OFFICIAL transcripts and other required documents are provided in a timely manner in order to complete my application.

I understand that if I fail to submit ALL of the required information within the specified time frame, my application may be considered incomplete.

I understand that I cannot qualify for interview until I have achieved a qualifying score on the AIR/NJATC Aptitude Test.

I hereby acknowledge that I bear the sole responsibility for completing my application following the instructions provided.

I understand that interviews for qualified applicants will be conducted in the order in which the applications are completed.

I understand that any intentional false statement or information that I provide on this application form or on other documents shall be cause for denial of oral interview or termination of indenture, should I be selected for the program.

I understand that an incomplete or unsigned application form will NOT be processed.

I understand that if selected, I will be required to complete the selection process by qualifying on any examination, including a physical examination or drug testing, if required by the sponsor; either before or after signing the indenture. I understand that only the ORIGINAL application form will be processed, and that photocopies are NOT acceptable.

I, THE UNDERSIGNED

...have darkened all the above (A thru M) to indicate my understanding, and state that, to the best of my knowledge, 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. I agree that any false statements made by me in this application 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 Standards, Rules and Policies covered by the indenture (Apprenticeship Agreement).

Signature*

Your Name
Your Name
Your Name

Date*

Text

EQUAL OPPORTUNITY -

WE ARE AN EQUAL OPPORTUNITY EMPLOYMENT UNION. We are dedicated to strict policy on non-discrimination in employment on any basial including: race, creed, color, age, sex, religion, national origin, disability, marital status, military status, or arrest record.

SUPPLEMENTAL INFORMATION FORM
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 against a qualified individual with a disability because of the disability of such individual. We respectfully request that you complete this form along with your completed application form for apprenticeship. 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. 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.

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