IBEW Local 105 - Journeyperson Application

Note: Copies of all licenses and certificates will be requested upon contact from IBEW LOCAL 105.

Please provide the following contact information:

Name:
Street Address:
Address (...con't):
City:
Postal Code:
Home Phone: xxx-xxx-xxxx
Email:
S.I.N: no spaces
Date of Birth: mm/dd/yyyy

Section 2:

2a. Certificate of Qualification Number:
2b. Journeyperson Classification:
2c. Are you legally eligible to work in Canada? yes no
2d. Have you been a member of a Union? yes no
If yes, please specify IBEW Local Union #

Other, please specify

Reason for leaving Union?

 

Section 3:

Experience in Trade: Please list four employers with dates and positions held

Employer:
Dates:
Positions Held

Have you had WHMIS training? yes no

Have you had FALL ARREST training? yes no

How long have your resided in Local Union 105 jurisdiction?

Licenses you now hold?                  

 

Section 4:

Apprenticeship History (employers and addresses)

1.
2.
3.

Section 5: Personal References: **please note, all references may be contacted**

In LOCAL 105:

1.
2.
3.

Other, with telephone numbers:

1.
2.
3.

5b. Please give reason for wanting to join LOCAL 105:

5c. Please list other trade areas and education/special courses taken:

5d. Have you ever been an electrical contractor? yes no

If yes, the name of your limited company:

address:

Todays Date:

 

          

Information supplied will not be distributed in any manner.  All information is strictly confidential!
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