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577 App
//
IBEW Local Union 577 Membership Application
Note that
ALL fields
are required.
Applicant Information
First Name:*
MI:
Last Name:*
Address:*
City:*
State:*
Zip:*
Phone Number:*
Email Address:*
Position Applying For:
Journeyman Electrician
Construction Electrician
VDV Technician
VDV Trainee
Desired Salary ($/hr):*
Are you a citizen of the United States?:*
Yes
No
If no, are you authorized to work in the U.S.? :
Yes
No
Education
High School
From:
To:
Did you graduate?:
Yes
No
Location:
College
From:
To:
Did you graduate?:
Yes
No
Location:
Degree:
Other
From:
To:
Did you graduate?:
Yes
No
Location:
Degree:
Date available for work:
Do you have a vehicle available for work?
Yes
No
Do you have a Driver’s License?
Yes
No
Are you willing to travel should work not be available locally?
Yes
No
Are you willing to travel within the state of WI?
Yes
No
Are you willing to relocate for a job?
Yes
No
Are you willing to work full time?
Yes
No
Do you consider yourself to have a work related disability?
Yes
No
Are you over age 18?
Yes
No
Do you have any prior experience?
Yes
No
Do you have any OSHA Training?
Yes
No
Do you have any First Aid/CPR Training?
Yes
No
Have you ever been an IBEW member before?
Yes
No
References
Full Name
Phone
Address
Occupation
Full Name
Phone
Address
Occupation
Full Name
Phone
Address
Occupation
For some positions, it may be required that employees possess certain physical capabilities. Check the appropriate boxes below, which you feel reflect the physical activities in which you can routinely engage without harm to yourself or fellow employees. Please be assured that a negative answer will not disqualify you from consideration.
Lifting :
Yes
No
Do you have difficulties :
Yes
No
List any physical limitations which you feel may relate to the work for which you are applying:
Please list all skills that will enhance your employment opportunities:
Do you have your own tools?
None
Some
Most
Work Experience
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason For Leaving:
May we contact your supervisor for a reference?
Yes
No
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason For Leaving:
May we contact your supervisor for a reference?
Yes
No
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason For Leaving:
May we contact your supervisor for a reference?
Yes
No
How many years have you worked in the industry?
Are you an IBEW member?
Yes
No
Have you ever completed a Registered Electrical Apprenticeship program?
Yes
No
Skills Experience
How Much Experience Do You Have with the Following:
No Experience
Some Experience
Very Experienced
Residential Wiring
Commercial Wiring
Industrial Wiring
Other
Rigid & IMC Conduit Bending, Threading & Installation
½" through 1"
1¼" through 2"
2¼" through 4"
Explosion Proof Work
PVC Conduit Bending and Installations
EMT (Electrical Metallic Tubing) Bending and Installation
½" through 1"
1¼" through 2"
Wire Pulling and Terminating
#16 through #2
#1 through 500 MCM
Speaker Cable
Telephone Cable
Coax & Computer Cable
Fiber Optic
Motor and Motor Control Wiring
AC Motor Wiring 1o
AC Motor Wiring 3o
Motor Controls
Programmable Controller Hook-up
Programmable Controller Programming
Other
Transformer Wiring
Control Transformers
Power Transformers
Other:
National Electrical Code Knowledge
Article 110 Electrical Installation Requirements
Article 200 Grounded Conductors
Article 210 Branch Circuits
Article 230 Services
Article 240 Overcurrent Protection
Article 250 Grounding & Bonding
Article 300 Wiring Methods
Article 310 Conductors
Low Voltage Systems
T.V.
Fire Alarm
Security
Speaker and Intercom
Other:
Service Installations
1o Service Installation
3o Service Installation
Electrical Systems
1o Systems (general wiring)
3o Systems (general wiring)
Disclaimer & Signature
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
Signature
Date
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