Application for ABC Apprenticeship Program Info: First name:* Middle name:* Last name:* Suffix: Date of birth:* SSN:* Gender: Male Female Ethnicity:* American Indian Or Alaskan Native Asian/Pacific Islander Black Hispanic Other White - Not Of Hispanic Orgin Veteran: Yes No Street:* Street 2: City:* State:* Zip code:* Primary phone number:* Email:* Apprentice type:* Carpentry Drywall Electrical Glazing Heavy Equipment Operations HVAC Instrumentation Insulating Ironworking Jumpstart Pre-Apprenticeship Program Masonry Pipe Fitter Plumbing School-To-Career Registered Apprentice Sheet Metal Sprinkler Fitting Answers: Do you have your own transportation?* Yes No EMPLOYMENT STATUS Are you currently with a participating employed?* Yes No Employer's name* Work phone Supervisor's name Job description <br /><br /><br /> EDUCATION Please indicate last grade completed* College High School Voc/Trade Name/location of institution* Years attended Course of study APPLICANT PROFILE - This information is required by the Maryland Apprenticeship & Training Council. Are you physically able to perform the duties of a construction trade?* Yes No How did you hear about the apprenticeship program? "I understand that all of the following requirements must be submitted with completed application to be scheduled for an interview." Please email or fax or mail the following requirements to: Fax: 410.870.5127 Email: apr@abcbaltimore.org Mail: PO Box 19069, Towson, MD 21284 DOCTOR'S CERTIFICATE - You must obtain a doctor's note stating that "YOU ARE PHYSICALLY ABLE TO WORK IN THE CONSTRUCTION FIELD". This note must be signed by the attending physician stating the date you were examined, and the date must be within the last six months, and must be on the doctor's letterhead or prescription pad. Any doctor's note NOT having the above information will not be accepted. PROOF OF AGE - Provide one of the following: Birth Certificate, Selective Service Card or Driver's License. COPY OF YOUR HIGH SCHOOL DIPLOMA or GED. PROOF OF WORK EXPERIENCE - You must obtain a letter from a current or previous employer stating the length of employment and the duties you performed, and must be signed by the employer. (Experience does not have to be in the selected trade but is preferred). VETERANS DISCHARGE (DD214)-IF APPLICABLE: You must supply a copy of your discharge papers if you served in the military. "I certify that to the best of my knowledge and belief, the above information is true and correct. I fully understand that it is my responsibility to provide my own transportation to and from all job sites and that the inability to do so may disqualify me from the ABC Apprenticeship Program." Electronic signature* Date*
