Application Form: Skills & Employment HistoryPersonal Information

Surname First Name

Street Address Apt # PO Box

City Province Postal Code

Email Birthdate (Day / Month / Year)

First Nations Band_________________________

Cell Phone: --------------------------------------------------------------- Home Phone:

Y N Were you referred to the Union? N

Education & Experience

Are you an indentured apprentice? Y N

What trade ________________________

If yes, what level technical training have you completed?

1 2 3 4

Are you a certified journeyperson? Y NTQ number

List previous employer

Employer 1 Employment dates Role or position

Employer 2 Employment dates Role or position

Employer 3 Employment dates Role or position

For office use only

Notes

Contacted: Y N init__________________ Date:______________________________

Do you identify as:

Inequality or Minority Group

Check all that apply.

Y N

Male Female Non-Binary Prefer not to say.

Y N

from:to:

from:to:

from:to:

Have you been or are you a Union member? Y

If yes, which Union/Local?If yes, by whom:

Jobsite Experience: Enter the number of years experience in:

Commercial Construction Residential Construction Industrial Construction

Jobsite Qualifications: Enter the number of years’ experience you have:

1 2 3 4 5+ or more years

Carpentry Scaffolding/Staging Wall & Ceiling

Concrete forming Yard work Boarding

Concrete placing Frame Scaffolding Insulation

Framing System Scaffolding Layout

Layout Tube and clamp Steel stud

Interior finish carpentry Swingstage Taping

Exterior finish carpentry Trims/accessories

Rough carpentry Labourer T-bar

Modular formwork Labouring Insulator

Lead hand experience Demolition & hazmat Pipe insulating

Foreman experience Concrete finishing Ship insulating

Supervisor experience Formwork stripping Metal cladding

Soft covers

Other Asbestos abatement

Trucking / delivery Lead abatement

Crane operation Fire stop systems

Rigging

Certifications: Copies of Certificates Must Be Given to Receive Credit

List any valid certifications

Aerial Boom Lift / AWP ☐ OFA ☐ Level 1 2 3

Bear Awareness ☐ Confined Space ☐

CSTS 09 / CSTS 2020 ☐ Fall Protection ☐

Driver’s License ☐ Rigging ☐

Fit Test ☐ Scissor Lift ☐

Flagging ☐ Skid Steer ☐

Forklift (Counterbalance Class 5) ☐ WHMIS 2015 ☐

H2S Alive ☐ Zoom Boom/Rough Terrain (Class 7) ☐

Hearing Test ☐ Other :