Apprenticeship Application

Applicant Information

Application Type

Equipment Operator Apprentice	Heavy Duty Repair Apprentice	Construction Building Inspector
Dredge Candidate	Plant Equipment Operator Apprentice	Rock Sand Gravel Apprentice

Social Security

Address

Last Name

Apt/Suite/Unit

First Name

City

Middle Initial

State/Zip Code

Name Suffix

Please Choose the Closest County to Where You Live

Home Phone

County/District

Cell Phone

Email Address

Verify Email

Education

Highest Year of Education Completed

High School(s)

High School Diploma
General Education Certificate
Associate Of Arts Or Sciences Degree
Bachelors Degree
Masters Degree

College(s) or Vocational School(s)

Background

Yes	No	Do you have a valid Driver's License?	Yes	No	Have you served in the US military?
License Class		Class A Class B Class C Other			If YES, please enter dates.
Yes	No	Do you have any trade experience?	Entry Date
Yes	No	Have you applied with this apprenticeship program before?	Discharged
		If YES, how many times?	Which Branch?
Yes	No	Have you participated in an apprenticeship of any kind?
If YES, in what?			List military training (MOS) you completed, if any.

Interest & Ability

Check All That Apply

Are You Able And Willing To Attend All Related Classroom Training Required?

Are You Available To Work Full-Time During Any Shift?

Are You Able To Train On Various Different Tasks, Skills, And Machinery When Out Of Work To Increase Your Knowledge And Skills?

Are You Able To Hear And Understand Verbal Instructions And Warnings Given In English?

EEOC Supplemental Information

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, sex or age, except the applicant must meet the minimum age requirement as specified in the standards. The JATC does not and will not discriminate against a qualified individual with a disability because of the disability of such individual.

This 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.

Date Of Birth	Number of Dependents	Number of Years You Have Been Employed in any Occupation Full-Time to Date (Except for Military Service)
	None	None
	One	Less Than 1 Year
Gender	Two	Year 1 But Less Than 2
Female Male	Three	2 But Less Than 3 Years
	Four	3 But Less Than 4 Years
	Five	4 But Less Thans 5 Years
	Six or More	5 Years or More

Ethnicity

Caucasian	Hispanic
Black	Native American, Alaskan Native
Asian, Pacific Islander	Did Not Disclose Ethnicity

Voluntary Disability Disclosure

Please check one of the boxes below:

YES, I HAVE A DISABILITY (or previously had a disability)

NO, I DON’T HAVE A DISABILITY

I DON’T WISH TO ANSWER

Why are you being asked to complete this form?

Because we are a sponsor of a registered apprenticeship program and participate in the National Registered Apprenticeship System that is regulated by the U.S. Department of Labor, we must reach out to, enroll, and provide equal opportunity in apprenticeship to qualified people with disabilities.[1] To help us learn how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for apprenticeship, any answer you give will be kept private and will not be used against you in any way.

If you already are an apprentice within our registered apprenticeship program, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our apprentices at the time of enrollment, and then remind them yearly, that they may update their information. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to: blindness, deafness, cancer, diabetes, epilepsy, autism, cerebral palsy, HIV/AIDS, schizophrenia, muscular dystrophy, bipolar disorder, major depression, multiple sclerosis (MS), missing limbs or partially missing limbs, post-traumatic stress disorder (PTSD), obsessive compulsive disorder, impairments requiring the use of a wheelchair, intellectual disability (previously called mental retardation).

__________________
[1] Part 30 – Equal Employment Opportunity in Apprenticeship. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Apprenticeship website at https://www.doleta.gov/OA/eeo/.

Statements Of Understanding

You must check ALL the Boxes. If you need clarification on any item contact Operating Engineers Training Trust.

Please Check All Of The Boxes Below Showing That You Read All Of The Following Rules Even If They Don't Apply To You.

I Have Read And Understand The Basic Qualifications For Entry Into This Program.

I Am Physically And Mentally Able To Safely Perform Or Learn To Safely Perform The Work Of This Trade, Either With Or Without Reasonable Accommodations.

If Accepted Into The Apprenticeship Program, I Have A Reliable Means Of Transportation To Get To Work And Training Site.

I Understand That Any Intentional False Statement Or Information That I Provide On This Application Form Or On Other Documents Shall Be A Cause For Termination Of Indenture.

I Understand That I Will Need Some Form Of Internet (Smartphone, Tablet, Computer) And Email Address To Enter My Monthly Work Hours After Becoming An Indentured Apprentice.

I Understand That If Selected, I Will Be Required To Complete The Selection Process By Qualifying On Any Examination Including A Drug Test.

I Have The Legal Right To Work In The United States Of America.

I Understand That To Participate In The Program I Must Be At Least 18 Years Of Age.

I Understand That I Will Need To Supply The Following Documents The Day I Become Accepted. A Certified Copy Of My Birth Certificate, Copy Of My High School Diploma, Equivalent (GED), Or College Degree.

Non-US Citizens: I Understand That I Will Need To Additionally Supply Paperwork That Authorizes Me To Legally Work In The U.S. On An Unrestricted Basis.

Veterans: I Understand That I Will Additionally Need To Provide My Report Of Military Separation (DD 214), To Receive The Awarded Additional Ten Points On My Entrance Examination.

I Understand That I May Apply For Prior Experience By Submitting My Documentation To OETT, And The Decision Is Wholly Left Up To The Director Of Training.

I Understand That I Will Need To Supply All Of The Documents Proving My Eligibility For Extra Test Points The Day Of Testing.

I have checked all the above to indicate my understanding, and state that, to the best of my knowledge, all information provided on this form is true and accurate. 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).

Please provide your firstname and lastname between two forward slash "/" symbols in order to indicate your agreement to these terms. (Examples: /firstname lastname/, /John Doe/)

Digital Signature

Date of Digital Signature

Input the Characters from the image above then Click Verify CAPTCHA

Application Entry

In order to complete this application, please fill in all the information requested in this document.

Prior to submitting this document, you will be required to fill out the CAPTCHA (Completely Automatic Public Turing Test to Tell Computers and Humans Apart) before submitting this application.

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