Prefix: First name:* Middle name: Last name:* Suffix: Date of birth:* Drivers license number:* Gender:MaleFemale Ethnicity:*American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhite Region:*AlaskaBellinghamBremertonDuPontDuPont/EverettEverettPortlandRentonSpokane Veteran:YesNo Disabled Street:* Street 2: City:* State:* Zip code:* Address type:BusinessHome Primary phone number:* Primary phone type:*CellFaxHomeOfficeOtherPagerWork Secondary phone number: Secondary phone type:CellFaxHomeOfficeOtherPagerWork Email: Email address type:HomePDAWork Apprentice type:*Applicant HVAC Controls TechnicianApplicant HVAC Service TechnicianApplicant Residential Sheet Metal WorkerApplicant Sheet Metal WorkerApplicant Test, Adjust and Balance TechnicianBham Building Trades Sheet Metal WorkerBham Residential Sheet Metal WorkerBham Service ApprenticeBham TAB ApprenticeBuilding Trades Sheet Metal WorkerHVAC Control TechnicianInstructorResidential Sheet Metal WorkerService ApprenticeTAB Apprentice
THE REMAINDER OF THIS FORM IS TO BE COMPLETED ENTIRELY BY THE APPLICANT
By signing your electronic signature below you are indicating my understanding, and to state that, to the best of your knowledge, all information provided on this form is true and accurate. I hereby grant permission to all former employers and references listed to disclose any information concerning my past employment and/or qualifications. 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).
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