PER UNION REGULATIONS, ALL EMPLOYEES MUST JOIN OUR DRUG FREE BUSINESS PROGRAM AND RECEIVE A DRUG SCREEN BEFORE BEGINNING EMPLOYMENT FAILURE TO COMPLETE ALL SECTIONS OF APPLICATION MAY RESULT IN AN INELIGIBLE APPLICATION Already a Union Member?(Required) Yes No Position(s) applying for(Required) Framer Hanger Taper Carpenter Office position Level of Experience:(Required) Apprentice Journeyman Utility person Other Which Local?Apprentice Bracket (if applicable)Other (Level of Experience)Last Name(Required)First Name(Required)Middle InitialHome Address(Required)CityStateZipUnion UBC ID(Required)Phone(Required)Email(Required) Do you have the legal right to work in the U.S.? Yes No All employment offers are contingent upon proof of eligibility to work in the U.S.Have you been convicted of a felony or released from prison within the last ten (10) years Yes No If yes, list date of conviction and nature of the charge. Conviction will not disqualify from employment & only be considered as it may relate to jobsite assignmentDate of conviction and nature of the charge.Equal Opportunity Employer:All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disabilities. Are you bi-lingual? Yes No If yes, what languages?Level of fluency Fluent Conversational Minimal EducationHigh SchoolLocationDegree/CertificateYears CompletedCollege or UniversityLocationDegree/CertificateYears CompletedBusiness/Tech SchoolLocationDegree/CertificateYears CompletedGraduate SchoolLocationYears CompletedDegree/CertificateOther Relevant Training or CoursesLocationYears CompletedDegree/CertificateCurrent License | Registration | CertificatesHilti | RamsetFirst Aid & CPRFall ProtectionHilti | RamsetOSHA 10OSHA 30Scaffold UserTelehandlerWeldingResidential RateAre you willing to work for Residential Rate on a Residential job? Yes No Work HistoryBegin with your most recent experience. List all jobs separately. Identify gaps in employment. A résumé will not substitute for the information required in this section. Employer(Required)Phone(Required)City(Required)State(Required)From(Required)To(Required)Job Title(Required)Supervisors Name(Required)May we contact this employer?(Required) Yes No Reason for Leaving(Required)Employer(Required)Phone(Required)City(Required)State(Required)From(Required)To(Required)Job Title(Required)Supervisors Name(Required)May we contact this employer?(Required) Yes No Reason for Leaving(Required)EmployerPhoneCityStateFromToJob TitleSupervisors NameMay we contact this employer? Yes No Reason for LeavingEmployerPhoneCityStateFromToJob TitleSupervisors NameMay we contact this employer? Yes No Reason for LeavingPlease explain any gaps of employment belowGender & Race | EthnicityGender Male Female Decline to answer Race | Ethnicity American Indian or Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or Pacific Islander Two or More Races White (not Hispanic or Latino) I decline to answer Veteran Status This company is also subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment veterans in the following classifications: A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability. A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An "active-duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An" Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.Veteran Status I identify as one or more of the classifications or protected veteran listed above I am not a protected veteran I decline to answer Why are you being asked to complete this form? We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years. Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp. How do you know if you have a disability? Autism Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS Blind or low vision Cancer Cardiovascular or heart disease Celiac disease Cerebral palsy Deaf or hard of hearing Depression or anxiety Diabetes Epilepsy Gastrointestinal disorders, for example, Crohn’s Disease, or irritable bowel syndrome Intellectual disability Missing limbs or partially missing limbs Nervous system condition for example. 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This field is hidden when viewing the formSignatureAccepted file types: jpg, gif, png, Max. file size: 512 MB.PER UNION REGULATIONS, ALL EMPLOYEES MUST JOIN OUR DRUG FREE BUSINESS PROGRAM AND RECEIVE A DRUG SCREEN BEFORE BEGINNING EMPLOYMENT FAILURE TO COMPLETE ALL SECTIONS OF APPLICATION MAY RESULT IN AN INELIGIBLE APPLICATIONFull Name /(Required)Please type your Full NameSignatureDate MM slash DD slash YYYY
