Application | bricktraining4inky.org

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Do you know someone involved in Bricklayers & Allied Craftworkers IN/KY Apprenticeship Program? *

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Yes, who?Yes, who?

Have you applied to the program before? *

Yes

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Do you have Military experience? *

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No

Have You Been Convicted of a Felony? *

No

Yes, explain:Yes, explain:

Are You Physically Able To Perform The Functions Of The Job? *

Yes

No

Are you currently employed? *

No

Yes, where and how long?Yes, where and how long?

Attach Copy of Birth Certificate *

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COMPLAINT PROCEDURE - TITLE 29 CFR 30.14 Any apprentice or applicant for apprenticeship who believes that he or she has been discriminated against on the basis of on race, color, religion, national origin, sex, sexual orientation, age (40 or older), genetic information, and/or disability with regard to apprenticeship, or that the equal opportunity standards with respect to his or her selection have not been followed in the operation of an apprenticeship program, may personally or through an authorized representative, file a complaint with the department of labor. The complaint must be filed not later than 300 days from the date of the alleged discrimination or specified failure to follow the equal opportunity standards. The complaint shall be in writing and shall be signed by the complainant. It must include the name, address and telephone number of the person allegedly discriminated against, the program sponsor involved, and a brief description of the circumstances of the failure to apply the equal opportunity standards. I CERTIFY THAT I HAVE RECEIVED A COPY OF THE COMPLAINT PROCEDURES IN ACCORDANCE WITH TITLE 29 CFR 30.14 * *

I agree

DRUG & ALCOHOL TEST THE TRUSTEES OF THIS FUND REQUIRE ALL APPLICANTS TO TAKE A DRUG AND ALCOHOL TEST. THE MANAGING DIRECTOR WILL DESIGNATE THE COLLECTION SITE AND DATE OF THE APPLICANT’S DRUG AND ALCOHOL TEST. THE APPLICANT AGREES THAT THE TEST RESULTS WILL BE SENT TO ROGER JONES, MANAGING DIRECTOR. FAILURE TO TAKE REQUIRED TEST WITHIN THE DESIGNATED TIME AUTOMATICALLY RESULTS IN THE APPLICANT’S REJECTION FROM THE PROGRAM. FAILURE TO PASS THE REQUIRED TESTINGS WILL RESULT IN THE AUTOMATIC REJECTION OF THE APPLICANT. AFTER AN APPLICANT IS REJECTED FOR FAILURE TO TAKE THE REQUIRED DRUG TEST OR FAILURE TO PASS THE REQUIRED DRUG TEST AN APPLICANT MUST WAIT THE MINIMUM OF ONE YEAR AFTER THE DATE OF THE DESIGNATED DRUG TEST TO REAPPLY. A RANDOM TESTING WILL BE CONDUCTED DURING PRE-APPRENTICE CLASSES. The Apprentice Applicant Agrees to Take a Drug & Alcohol Test and to Release the Results to BAC 4 IN/KY Apprenticehip & Training Program * *

I agree

AFFIRMATIVE ACTION INFORMATION FORM The following information is being requested to comply with government regulations. The requested information is for affirmative action statistical purposes only and will not be kept with your application.

Gender *

Race *

Ethnic Group *

Disability *