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Application Form: Skills & Employment History Personal 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 N TQ 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:

Application Form: Skills & Employment Historybcrcc.ca/wp-content/uploads/2020/04/200402...CSTS 09 / CSTS 2020 ☐ Fall Protection ☐ Driver’s License ☐ Rigging ☐ Fit Test ☐

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Text of Application Form: Skills & Employment Historybcrcc.ca/wp-content/uploads/2020/04/200402...CSTS 09 /...

  • 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 :

    Surname: First Name: Street Address: Apt: PO Box: City: Province: Postal Code: Email: Birthdate Month Day Year: What trade: TQ number: Employer 1: Role or position: Employer 2: Employment dates_2: Role or position_2: Employer 3: Role or position_3: Notes: init: Date: Cell Phone: Home Phone: Referral: Dropdown6: [0]Dropdown7: [0]Dropdown8: [0]Dropdown9: [0]Dropdown10: [0]Dropdown11: [0]Dropdown12: [0]Dropdown13: [0]Dropdown14: [0]Dropdown15: [0]Dropdown16: [0]Dropdown17: [0]Dropdown18: [0]Dropdown19: [0]Dropdown20: [0]Dropdown21: [0]Dropdown23: [0]Dropdown24: [0]Dropdown25: [0]Dropdown26: [0]Dropdown27: [0]Dropdown28: [0]Dropdown29: [0]Dropdown30: [0]Dropdown31: [0]Dropdown32: [0]Dropdown33: [0]Dropdown34: [0]Dropdown35: [0]Dropdown36: [0]Dropdown37: [0]Dropdown38: [0]Dropdown39: [0]Dropdown40: [0]Dropdown41: [0]Dropdown42: [0]Dropdown43: [0]Dropdown44: [0]Dropdown45: [0]Group1: OffGroup2: OffBand Name: Group3: OffGroup4: OffGroup5: OffText3: Text4: Text5: Group6: OffCheck Box8: OffCheck Box9: OffCheck Box10: OffCheck Box11: OffCheck Box12: OffCheck Box13: OffCheck Box14: OffText23: Button24: Check Box6: OffCheck Box15: OffCheck Box16: OffCheck Box17: OffCheck Box18: OffCheck Box19: OffCheck Box20: OffCheck Box21: OffCheck Box22: OffCheck Box7: OffGroup7: OffGroup8: OffText25: Group9: OffGroup10: OffEmployment dates: Employment dates 1: Employment dates 2 to: Employment dates_3: Employment dates_3 to: