Pre-Apprenticeship Application

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Alternate Phone

(###)

###

####

What program are you applying for? *

Construction Pre-Apprenticeship

Construction Workshop

Do you have a valid driver's license? *

Yes

No

Do you have a photo ID/license and original Social Security card? *

Yes

No

Do you have your HS diploma/GED? *

Yes

No

If no, are you either enrolled in a GED program or attending High School? *

Yes

No

N/A

Are you able to work legally ? *

Yes

No

Do any of the following apply to you? *

Criminal record

English language learner

Homeless

Underemployed (you were working but not enough hours)

Disabled (including learning disabilities)

Long term unemployed (NOT working for 26 weeks or more)

Not applicable

Check any public assistance programs you receive benefits from: *

Food stamps in the last 6 months

TANF

SSI

N/A

Other

What date are you available to begin training? *

MM

DD

YYYY