INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL 49
and
ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA
APPRENTICESHIP AND TRAINING PROGRAM

40276 Fishtail Road
Hinckley, MN 55037
Phone: 320-384-7093
Email: apprentice@local49training.org

Geoff Movold

Director

APPLICATION FOR APPRENTICESHIP

Dirt

Dirt

Crane

Crane

Are you 18 years or older

Yes

Are you a US citizen or in the process of naturalization

Yes

Are you a high school graduate or possess a GED.

Yes

Are you 18 years or older no

No

Are you a US Citizen or in the process of naturalization no

No

Are you a high school graduate or possess a GED. No

No

I have a valid drivers license of which is a

Class A

Class A

Class B

Class B

Class C

Class C

Class D

Class D

NOTICE TO APPLICANT:

The information you provide to complete this page is for affirmative action tracking purposes. See the reverse of this page for data explanations.

First Name *

Middle Name

Last Name *

Street Address *

Apt. or Box No.

City *

County

State *

Zip *

Social Security Number

Email *

Sex

Male

Sex Female

Female

Racial/Ethnic Group

American Indian/Alaskan Native

American Indian/Alaskan Native

Asian

Asian

Black/African American

Black/African American

White

White

Hispanic

Hispanic

Other

Other

Have you applied for this training before?

Yes

Have you applied for this training before no?

No

Are you disabled/handicapped?

Yes

"Disability/handicap" is defined as "a handicapping condition which substantially limits one of life's major activities such as walking, caring for yourself, seeing, hearing, speaking, performing manual tasks, breathing, learning, working." Do not answer "Yes" to this question if, for example, you have a visual problem corrected by glasses.

Are you disabled/handicapped No?

No

Cell phone number *

Alternate telephone number

Are you legally authorized to work in the United States?

Yes

Are you legally authorized to work in the United States No?

No

Are you a Veteran?

Yes

Are you a Veteran No?

No

Where did you hear about the Local 49 Apprenticeship

WDI

WDI

School fair/career day

School fair/career day

Community event

Community event

State/county fair

State/county fair

Internet

Internet

Other

Other

IMPORTANT FACTS ABOUT INFORMATION ON YOUR APPLICATION

This application is to assist in the process of referring you to employers for possible employment. Certain information requested on the application is private, that is, it may be released only to you or to governmental agencies.

Private Data	Why We Ask For It	Are You Legally Obligated To Provide It?	What May Happen If You Don't Provide It?
Social Security Number	To distinguish you from all other applicants and to make processing more efficient.	No	You will be assigned an individual identification number In order to insure that your records will not be confused with those of another applicant. You will have to use the number when contacting the committee concerning any of your records.
Name/Address	To distinguish you from all other applicants; to be able to send you notices	Yes	Failure to provide information may be cause for rejecting an application
Home Telephone	To be able to contact you to determine availability for interview	No	We may not be able to employ you in certain jobs where you may be required to come to work on short notice.
Sex, Racial/Ethnic* Group, Handicapped Status**	To be able to make Equal Opportunity reports as required by law and to provide affirmative action in apprenticeship.	No	We will not be able to determine whether our selection processes result in unfair discrimination or to take affirmative action in our hiring

* NOTE: Minn. Stat. 254A.02, Subd 11 defines American Indian as "American Indian means a person of one quarter or more Indian blood."

** NOTE: "Disability/handicap" is defined as "a handicapping condition which substantially limits one of life's major activities such as walking, caring for yourself, seeing, hearing, speaking, performing manual tasks, breathing, learning, working. Do not answer "yes" to this question if, for example, you have a visual problem corrected by glasses.

ALL OTHER INFORMATION ON THE APPLICATION IS PUBLIC, THAT IS, IT MAY BE GIVEN TO ANYONE FOR ANY PURPOSE.

EMPLOYMENT CONDITIONS

You should be aware that in this construction trade, you must travel to various construction projects located within the entire State of Minnesota covered by the Operating Engineers Joint Apprenticeship Committee's jurisdiction. You must have reliable means of transportation to travel to these projects.
A requirement of this or any registered apprentice program is attendance of at least 144 hours per 2000 hours worked of related training outside your normal working hours. You will be required to attend these related training classes without monetary compensation.
Employment in this trade may not be full time and there may be periods of unemployment due to weather, economic conditions and other circumstances.
Apprentices start at a percentage of the journey worker's rate and receive periodic increases. These increases are not automatic but depend on the progress made by the apprentice in on-the-job training and related training.
This occupation could involve the lifting of heavy objects, working in confined areas, and high places.
When an offer of employment has been made, the applicant may be required to submit to a physical examination which may include drug testing.

I HAVE READ AND UNDERSTAND THESE EMPLOYMENT CONDITIONS AS REQUIRED BY THE OCCUPATIONS.

Signature *

Date *

First Name *

Middle Name

Last Name *

Date

SECTION 1. EDUCATION

High School Name

High School City

High School State

High School Diploma

High School G.E.D

Vocational School Name

Vocational City

Vocational State

Vocational Degree

College Name

College City

College State

College Degree

SECTION 2. JOB RELATED SKILLS OBTAINED THROUGH OTHER SOURCES

IF YOU HAVE WORKED IN CONSTRUCTION OR OPERATED EQUIPMENT IN A RELATED FIELD, PLEASE DESCRIBE

DESCRIBE MECHANICAL BACKGROUND (engine repair, assembly,welding, etc)

ARE YOU REQUESTING CREDIT FOR PAST EXPERIENCE?

SECTION 3. Employment History

1) Organization:

1) Location:

1) Position:

1) Supervisor:

1) Employment To:

1) Employment From:

1) Major Activities:

1) full

Full-time

1 part

Part-time

1) Machines/equipment you used:

1) Hrs/Wk

2) Organization:

2) Location:

2) Position:

2) Supervisor

2) Employment To:

2) Employment From:

2) Major Activities:

2 Full

Full-time

2 Part

Part-time

2) Machines/equipment you used:

2) Hrs/Wk:

3) Organization:

3) Location:

3) Position:

3) Supervisor:

3) Employment To:

3) Employment From:

3) Major Activities:

3) full

Full-time

3 part

Part-time

3) Machines/equipment you used:

3) Hrs/Wk:

IMPORTANT

I declare that any statement in this application or information provided is true and complete and hereby acknowledge that I have read and understand the information below.

Signature *

Date *

The Committee reserves the right to verify information provided in the application.
In connection with this application for employment I authorize the Operating Engineers Local 49 Joint Apprenticeship Committee to conduct an inquiry into any job related information contained in this application, including, but not limited to, my records maintained by an educational institution relating to academic performance such as transcripts. Moreover, I hereby release the Committee from any and all liability of whatsoever nature by requesting such information from any person.

Call Supervisor

YES

Call Supervisor Yes but

YES, but not present employer until job offered.

Call Supervisor No

NO (we may be unable to hire you without this information)

Name and phone number of current or most recent supervisor who may be contacted as an employment reference

PLEASE EXPLAIN BRIEFLY WHY YOU ARE INTERESTED IN BECOMING AN OPERATING ENGINEER APPRENTICE: