JOINT APPRENTICESHIP & TRAINING PROGRAM
Application for Apprenticeship
* Required Information
 
* Name:
* Social Security Number:
 
* Address:
* (County) * (City) * (State) * (Zip)
Phone:
* U.S. Citizen:
* Have you registered for Selective Service?
* Date of Birth: * Place of Birth:
* Gender: Male Female
* Race:
Non Hispanic White Non Hispanic Black Hispanic
Asian or Pacific Islander American Indian or Alaskan Native Other
 
Education
High School :
* Grade Completed:
* GED:

Vocational/Trade School:
Attended: Years Attended:
Course of Study:

College:
Years Attended:
Major Course of Study:

Certifications: If you hold any certifications, please list them below
 
Work History
Length of Mechanical Insulation Trade Experience: Years, Months
Companies and time spent with each:

Type of Jobs worked on - Approximate Time:
Schools: Powerhouse:
Hospitals: Shop Work (Prefabrication):
Industrial Plants: Light Manufacturing:

List the Materials you have applied to the following items:
 
Straight Pipe Runs
 
  Pipe Bends, Elbows, Valves, Tees, Etc.
 
  Special shaped equipment & vessels: Tanks, Pumps, Hot water generators, Exchanges, Chillers, Etc.
 
  Duct work and Breechings
 

Check the jobs you have performed:
1. Hot application of preformed pipe or block insulation
To straight piping
To pipe bend, elbows, valves, etc.
To vessels and special-shaped equipment

2. Cold application of preformed pipe or block insulation
To straight piping
To pipe bend, elbows, valves, etc.
To vessels and special-shaped equipment

3. Application of flexible insulation/Duct wrap & etc.
To straight piping
To pipe bend, elbows, valves, etc.
To vessels and special-shaped equipment
Rigid board to ducts, elbows & bends

4. Application of sealing compounds in relation to
To straight piping
To pipe bend, elbows, valves, etc.
To vessels and special-shaped equipment

5. Mixing and application of wet composition to pipe work and equipment
First and second-coat work
Finishing coats (Including quick-setting cements)

6. Finish of insulation with sheet-metal
To straight piping
To pipe bend, elbows, valves, etc.
To vessels and special-shaped equipment
Prefabrication of sheet metal, for elbows, tees, valves and etc.

7. Application of fireproofing materials to steelwork

8. Wrapping with ceramic fibers, cloths and similar materials

9. Fitting of insulation supports
Pin welding
Stud welding
Independent framework, roadmesh, poultry netting

10. Application of canvas and glass cloths
To straight piping
To pipe bend, elbows, valves, etc.
To vessels and special-shaped equipment

11. Use of power tools
Band saws (Shop fabrication)
Drills, others

12. Use of spraying equipment for mastics

13. Use of spray equipment for urethanes for cold work

14. Other work not covered by all of the above list below
   

* Have you ever been terminated or laid off as a result of a company closure?
If Yes:  
Please list the company and location:
Approximate date of layoff:
Are you currently employed?
If Yes:  
Employer:
Start Date:
Job Title:
Hours Per Week:
Job Duties:

Work History (list most recent first)  
* Employer:
* Start Date:
* Job Title:
* End Date:
 
Hours Per Week:
Job Duties:
Reason for Leaving:

* Employer:
* Start Date:
* Job Title:
* End Date:
 
Hours Per Week:
Job Duties :
Reason for Leaving:

* Employer:
* Start Date:
* Job Title:
* End Date:
 
Hours Per Week:
Job Duties :
Reason for Leaving:
Are you authorized to work in this country?

* Veteran?
If Yes:  
Branch of Service:
Years Served:
Special Training:
Type of Discharge:

* Are you willing to attend, on your own time, training classes, and any meetings scheduled by the Committee?
* Do you realize there is no guarantee of continuous or stable employment?
* Have you ever applied for any apprentice training?
When: Where: Which Trade:
* Does it bother you to work in high places or off scaffolds?
* Does it bother you to work in confined spaces?
* Will it bother you to work with hazardous materials after adequate training?
Reason for wanting to be an Asbestos Worker:
How did you find out about the availability of our apprenticeship?  
 
 
Work Experience References
1.
* Name:
* Address:
* Phone:

2.
* Name:
* Address:
* Phone:

3.
* Name:
* Address:
* Phone:
 
Character References
1.
Name:
Address:
Phone:

2.
Name:
Address:
Phone:

3.
Name:
Address:
Phone:
 

You are required to mail in copies of…

Drivers License (if applicable)
Social Security Card
High School Diploma or GED (if applicable)
Grade Transcripts (if applicable)
Any Certifications (if applicable)

Please send to the address listed below

3263 Schoolhouse Road,
Middletown, PA 17057

 
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