IEC Apprenticeship Application

Personal Information

Please fill in your contact info below.

First Name

Middle

Last Name

Prefix

Suffix

Nick Name

Address:

Unit/Apt. Number:

Address Type:

Email Address

Type

Phone Number

Type

Secondary Phone

Type

Emergency Contact 1

Phone

Relationship

Emergency Contact 2

Phone

Relationship

Employer Name

Date Hired

SSN

Date of Birth

Drivers License

Gender

Ethnicity

Disabled

Veteran

Highest Educational Level (attained): Comment on my response

Are you Hispanic or Latino? Comment on my response

Are you a CLC Student? Comment on my response

Governmental Information

Are you legally eligible for employment in the United States? (required)

Comment on my response

Are you willing to take a Drug Test? Comment on my response

Are you registered with Selective Service? Comment on my response

Within the last 7 years, have you been convicted or pleaded no contest to or received deferred adjudication for any crimes, including DWI? (excluding minor traffic violations)

Comment on my response

Do you have a disability? Comment on my response

Category of Disability Comment on my response

Do you receive State Developmental Disabilities Agency Services (SSDA)?

Comment on my response

Do you receive local or state Mental Health Agency services (LSMHA)?

Comment on my response

Do you receive services under state Medicaid HCBS Waiver?

Comment on my response

Military Service (if applicable)

Are you eligible for Veteran Education (V.A.) Benefits?

Comment on my response

Years of service Comment on my response

Military Separation Date

Comment on my response

Are you an Eligible Veteran? Comment on my response

Are you a Disabled Veteran? Comment on my response

List any duties or training received in the military applicable to electrical construction

Comment on my response

Are you a transitioning Service member? Comment on my response

Are you a homeless Veteran? Comment on my response

Employment Information

Are you currently employed? Comment on my response

Current/Most Recent Employer Name/Contact Information

Comment on my response

May we contact this employer? Comment on my response

Second Most Recent Employer Name/Contact Information

Comment on my response

May we contact this employer? Comment on my response

Third Most Recent Employer Name/Contact Information

Comment on my response

May we contact this employer? Comment on my response

Are you a Migrant Seasonal Farmworker? Comment on my response

Education Information

Have you previously applied for this program?* Comment on my response

Highest Grade Level Completed: Comment on my response

Highest Education Level Completed Comment on my response

Have you attended a Trade/Technical/Apprenticeship School?

Comment on my response

Specify the number of semesters you have taken in each of the following subjects:

Algebra Comment on my response

Geometry Comment on my response

Chemistry Comment on my response

Physics Comment on my response

Drafting Comment on my response

Electricity Comment on my response

List any Honors/Recognitions: Comment on my response

List any Skills/Training that apply to the electrical construction field that you might have.

Comment on my response

Have you had any work-related safety training? Comment on my response

Public Assistance Information

Have you received cash assistance or other supports services from the Temporary Assistance for Needy Families (TANF) agency in the last six months?

Comment on my response

If you receive TANF cash assistance, are you within 2 years of exhausting lifetime eligibility?

Comment on my response

I currently receive or have received SSI Assistance in the last 6 months

Comment on my response

I currently receive or have received SSDI Assistance in the last 6 months?

Comment on my response

I am a Ticket to Work Program Ticket Holder? Comment on my response

I currently receive or have received State and/or Local government assistance in the last 6 months?

Comment on my response

I currently receive or have received Refugee Cash Assistance (RCA) in the last 6 months?

Comment on my response

Young Parent with Dependents (check all that apply)

Comment on my response

Young Adult Status Comment on my response

Young Adult Foster Care Status Comment on my response

Homeless Status (check all that apply) Comment on my response

Supplemental Nutrition Assistance Program (SNAP) Comment on my response

Other Low Income Information (check all that apply)

Comment on my response

English Language (check all that apply) Comment on my response

Cultural Barrier to Employment Comment on my response

Single Parent (check all that apply) Comment on my response

Are you a Displaced Homemaker? (See description below)

Comment on my response

Required Documentation

The required documentation listed below MUST be received at our admin@iecfwtc.org inbox before your application will be accepted:

Driver's License or Photo ID
Social Security Card (or Birth Certificate)
Proof of High School Graduation/GED
Selective Service Letter (males only)
Copy of Electrical Apprentice License

Once your application is submitted, you will receive an email with instructions on where to send these documents. Or, you may upload these files below.

Driver's License

Comment on my response

Social Security Card

Comment on my response

Birth Certificate

Comment on my response

High School Transcript or Diploma

Comment on my response

Selective Service Letter (males only)

Comment on my response

Copy of Electrical Apprentice License or Approval

Comment on my response

Thank you for your application. Once received, we will be reaching out to you via email with further instructions. Please look for an email from admin@iecfwtc.org in the near future.

* Required field