Application for Pre-apprenticeship and Apprenticeship Cement Masons 404 Joint Apprentice & Training Program

Present Address
Previous Address
Education: (All schools above Elementary)
Work Experience (Last three occupations - list most recent employer first)
References: List (3) Relatives
List three (3) persons, NOT relatives or employers, with whom you are well acquainted
Have you ever been convicted or pled no contest for any violation of any Federal, State, or municipal law or ordinance?
- DO NOT include anything that occurred before your 16th birthday.
- DO NOT include traffic violations for which a fine of $25.00 or less was imposed.
Convicted or No Contest Pleas (Other than minor violations)
Certification
I have read all of the above questions. I certify that the information furnished in answer to these questions is correct and complete to the best of my knowledge and belief, and I understand that it is of great importance in the consideration of my eligibility for apprenticeship. I make this statement to the Joint Apprenticeship Committee with the understanding that it will be used by the Committee in carrying out its duty in selecting Pre-Apprenticeship and Apprenticeship applicants. I further understand that any false statement or omission of material fact may be sufficient cause for rejection of my application, or dismissal after my indenture or employment.
Release
I hereby release all previous employers, references or other persons from any and all liability and damage of whatsoever nature on account of furnishing information requested which is to be used in determining my fitness for an apprenticeship in the Cement Mason's Apprenticeship Program
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