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DETACH AND RETAIN FOR YOUR RECORDS
PLUMBING MADISON AREA PLUMBING
APPRENTICE APPLICATION JOINT APPRENTICESHIP COMMITTEE
5940 Seminole Centre Court, Suite 102
Madison, Wisconsin 53711
(608) 288-1414 Fax (608) 288-1515
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Qualifications Necessary for an applicant to be considered for a Plumbing Apprenticeship:
- Must be a high school graduate, have received a G.E.D., or a high school senior in good standing.
- Complete, sign and date this application and return along with the EEOC Supplemental Information Form and a copy of your high school diploma, high school transcripts or G.E.D. or High School Equivalency Certificate.
- Successfully complete an aptitude test, when scheduled.
- Be interviewed by the Committee to determine if you meet the minimum qualifications.
** "Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m)]"
Please Print or Type
Application Date: ___________________________Applicants Social Security No: _________________________________
Applicants Legal Name: _________________________________________________________________________________
(First, Middle Initial, Last)
Applicant's Address: ____________________________________________________________________________________
(Street, City, State, Zip Code) (County)
Date of Birth: ______________________________Area Code & Telephone Number:(_____)__________________________
Parent or Guardian Name: _______________________________________________________________________________
(If applicant is under 18 years of age)
Education and Training Background:
_______ High School Graduate ________ GED _______ High School Equivalency
Indicate highest grade or year completed in school: 1 2 3 4 5 6 7 8 9 10 11 12
Year diploma was granted _____________ Name of School ______________________ City_________________________
Was your diploma issued under another Name? _________Yes _________No
If yes, indicate name:____________________________________________________________________________________
Baccalaureate/Technical College:
Indicate the highest number of semesters completed 1 2 3 4 5 6 7 8 9 10 11 12
Name of School: _______________________________ City ________________________ State _____________________
Major Course of Study ____________________________ Minor Course of Study _________________________________
Did you receive a diploma/degree? _________Yes _________ No If yes, year degree granted: ____________________
Trade Related/Military School/Correspondence Course/ Other
(If more space is needed, attach separate sheet)
Name of School ________________________________ City ________________________ State ______________________
Major Course of Study ____________________________ Hours or Units of Study Completed ______________________
Did you receive a certificate of completion? ___________Yes ___________No If yes, what year? _________________
Previous Employment (Including Military):
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Military Background:
Veteran of Military Service: ________ Yes _______ No Active Reserve or Guard Member ______ Yes ______No
Eligible for Veterans Training Benefits: __________ Yes __________ No __________ Not Sure
If you are a veteran, contact your county veteran's service office for benefit assistance.
I am legally able to drive in the State of Wisconsin _____________ Yes ____________ No
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Applicant Signature Date