Submit Details for More Information on Membership

Note that ALL fields are required.

First Name:*

MI:

Last Name:*

Present Address:*

City:*

State:*

Zip:*

How long have you lived at this address:*

Do you have a valid Drivers License?*

Yes

Email Address:*

Phone Number:*

Cell Phone Number:*

Are you over 18 years of age?*

Yes

Are you legally eligible to work in the United States?*

Yes

Sex:*

Male

Female

Race:*

American Indian or Alaskan Native

Black (Not Hispanic Origin)

Hispanic

Asian or Pacific Islander

White (Not Hispanic Origin)

EDUCATION

High School:

Years Attended:

Did You Graduate?:*

Yes

Subjects Studied:*

College:

Years Attended:

Did You Graduate?:*

Yes

Subjects Studied:*

Trade School:

Years Attended:

Did You Graduate?:*

Yes

Subjects Studied:*

Additional Ed.:

Years Attended:

Did You Graduate?:*

Yes

Subjects Studied:*

Special Lic:

Years Attended:

Did You Graduate?:*

Yes

Subjects Studied:*

GENERAL

Do you have military experience?:

If so what rank?:

Honorable Discharge?:*

Yes

EXPERIENCE

How long have you been doing electrical construction?:*

Are you currently employed?:*

Yes

Have you ever been a member of the IBEW?:*

Yes

If Yes which Local?:

When?:

Have you ever applied for IBEW membership?:*

Yes

If Yes which Local?:

When?:

Have you ever applied for an IBEW Apprenticeship?:*

Yes

If Yes where?:

When?:

Were you interviewed?:*

Yes

Have you completed or been enrolled in any electrical training programs?:*

Yes

If Yes, which one(s):*

ABC

IBEW

IEC

Ivy Tech

Other

WORK HISTORY

Which of the following phases for electrical installations have you performed?

Conduit Bending & Installation

Residential Wiring

Transformers

Rigid

Single Housing

Substations

EMT

Condos

Cable Splicing

PVC

Apartments

Electronic Controls

Hydraulic Conduit Bending

High Risers

PLC’s

Concrete Slab Installation

Hotels

HMI’s

Commercial Installation

Underground Dist

VDV

Industrial Wiring

Overhead Line Work

Alarm Systems

Maintenance & Trouble Shooting

Tilt-ups

Other

Control Wiring

Supervision

Complete the following for each of the contractors you have been employed with; starting with your current/most recent employer (please be as thorough and accurate as possible).

1. Employer:* Address:*
When were you employed?:*
to
Starting Wage?: Ending Wage?: Did you receive any benefits?:*

Yes

If Yes, Explain:
Why Did You Leave?:

2. Employer:* Address:*
When were you employed?:*
to
Starting Wage?: Ending Wage?: Did you receive any benefits?:*

Yes

If Yes, Explain:
Why Did You Leave?:

3. Employer:* Address:*
When were you employed?:*
to
Starting Wage?: Ending Wage?: Did you receive any benefits?:*

Yes

If Yes, Explain:
Why Did You Leave?:

4. Employer:* Address:*
When were you employed?:*
to
Starting Wage?: Ending Wage?: Did you receive any benefits?:*

Yes

If Yes, Explain:
Why Did You Leave?:

How did you find out about the IBEW? (Check all that apply)

Printed Materials

Wholesale House

Organizer

Friend/relative

Union Video

Website

Other

Do you know anyone who is a member of IBEW Local #429?

Yes

If yes, who?:

Why are you applying to IBEW Local 429?

Do you currently hold any type of license(s) (Electrical, CDL, etc.)

Yes

If yes, explain?:

Do you hold any Training Certificates of any kind?

Yes

If yes, explain?:

Are you willing to submit to a drug test per the Labor-Management Committee Policy?

Yes

Are you inquiring about?

Inside Electrical Work (Construction Wireman, Construction Electrician, Apprentice, Journeyman)

Residential

Telecommunications

If deemed necessary, are you willing to take additional training or apprenticeship training?

Yes

Have you ever completed OSHA 10 or 30?

Yes

If Yes, 10 or 30, When & Where?

In order for us to process you application, we must have verifiable proof of electrical construction experience on file based on hours worked. Can you provide documentation of work experience through paycheck stubs or other written documents?

*I understand that submitting this application does not promise employment of any kind through IBEW Local 429. Due to numerous factors, including the economy, hiring needs of our signatory employers, availability of work opportunities, nothing is implied or guaranteed.

Signature

Date

Release of Prior Personnel Records
By signing this employment information sheet, I agree that all of the information now or later given by me in support of my employment information sheet for possible employment is true and complete. I understand that you may verify any of the information concerning my employment, education, credit, or medical history with the appropriate individuals, organizations, or governmental agencies. I give these individuals, organizations, or governmental agencies my permission to release any information that you need, including my pervious disciplinary record, without requiring them to contact me or give me written notice before revealing the information to you. I understand that no verification of my credit history or request for a “consumer report” under the Fair Credit Reporting Act may be undertaken by you without my express written authorization in a separate document.

Signature

Date

Member Login

Submit Details for More Information on Membership

EDUCATION

GENERAL

EXPERIENCE

WORK HISTORY