SOUTHERN ILLINOIS CARPENTER APPRENTICESHIP APPLICATION


    
  Date: 
   Legal Name       Last:     First:      MI:           SSN:  
                        Address:  
                    City, State:        Zip Code  
                           Phone:  
                   Cell Phone:  
                            eMail:  
                    Birth Date:   * * *  Age:  
Questions below are asked in compliance with regulations issued by the Equal Employment Opportunities Commission under Title 7 of the Civil Rights Act of 1964. Your answer will be kept confidential, and will not be used for any purposes other than Apprenticeship Information Reporting.
(Check One)
Male
Female
Ethnic Group:
African American (Not Hispanic)
Asian or Pacific Islander
American Indian or Alaskan Native
White (Not Hispanic)
Hispanic
Bosnian/Russian
Not Elsewhere Classified

(Check One)
Veteran
Non-Veteran

Person to Contact In Case of Emergency:
            Name              Relationship  
         Address                                                                                                         Telephone No.
    City, State                  Zip Code                            Cell Phone No.
I learned about the apprenticeship program from:
A Friend
Newspaper
Family member
Internet/Website
Career Day (please describe)   
School (please describe)            
Other(please describe)              

By submitting this application I hereby agree that:
I understand for this application to be finalized it is my responsibility to present photo identification(i.e.,
driver's license, etc.) with proof of age in person. By submitting this application, I approve the release of my
pre-employment and apprenticeship records from the St. Louis Carpenters Joint Apprenticeship Program
to any contractor participating in the apprenticeship program or any sponsoring community organization.