Apprenticeship Application

First Name

Middle Name

Last Name

Email

Address

City

State:

Zip Code

Cell Phone

Cell Phone Carrier:

SSN

Date of Birth

NAME CHANGE: Please provide the name that will appear on documents or transcripts that you submit, if it is different than your present name.

First Name

Last Name

Indicate your Means of Qualification for Apprenticeship

	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 The name of the Contractor is:
	I am among the 50%, or more, who signed authorization cards while working for an electrical contractor during an organized effort The name of the Contractor is:
	I am attempting to qualify for, and participate in the School-Registered-Apprenticeship Program
	I am attempting to transfer into this program from another IBEW/NECA registered apprenticeship program for the same trade

Education

Indicate the years of formal education you have completed

Are you a High School Graduate or at least 17 years old and a High School Senior?

Yes

No

If NO, do you have a GED?

Yes

No

List College Degree(s) earned

Degree

Major

School

Second Highest Degree earned

Degree

Major

School

Have you received one full credit for Algebra, or some higher math course, from an accredited school?

Yes

No

Indicate course completed

NJATC Tech Math

Indicate Math course(s) completed

	Algebra 1
	Algebra 2
	Geometry
	Trigonometry
	Calculus

Have you completed any vocational/technical courses or training during or after high school?

Yes

No

List training or courses you have completed:

Background

Have you ever served in the US military?

Yes

No

If YES, how long in months?

Which Branch?

	Army		Navy
	Air Force		Marines
	Coast Guard		Military Reserve

List which military training schools you completed, if any:

Honorably discharged veterans may be eligible for reimbursement of their application fee. Please enter your service number located on your DD-214:

Have you ever been convicted of a felony?

Yes

No

If YES, explain the conviction:

Apprenticeship Application

MINIMUM REQUIREMENTS: (and documentable proof of the following):

Education

List College Degree(s) earned

Second Highest Degree earned

Background