Local 493 Application Form

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Applicant Information

First Name

Last Name

Address

City / Town

Province

Postal Code

Home Phone

Cell Phone (Optional)

Email

Date of Birth

Sex
MaleFemale

Are you currently a member of any union?

YesNo

If yes, which union?

Any injuries or disabilities?
YesNo

Any physical restrictions?
YesNo

If yes, please explain:

Work Experience

Company

Start Date

Finish Date

Reason for Leaving

Contact for Reference

Please check any of the following skills that you may have:
Blueprint reading and supervision (Maintenance)Cement finishing (Concrete Technology)Formsetting (Carpentry)Pipelayer / Gradesman with laser/transitScaffold Erection & DismantlingRailroad maintenanceSPRAT – rope accessAerial lift and/or scissor liftTelehandlet forkliftWHMISBasics of supervisingNAUSC foreman certification Asbestos abatement workerPipeline safetyFall protectionPropane in constructionChainsaw safetyHoisting and rigging Confined space / safety watchTraffic controlCPR / first aidTrenching safetyForkliftSkidsteer / Bobcat

Criminal Convictions

Have you ever been convicted or found guilty of any criminal offence?
YesNo

If yes, please explain (charges, dates, country, etc):

I agree to the following:

1. FALSIFICATION OR MISINTERPRETATION OF INFORMATION ON THIS APPLICATION INCLUDING OMISSION OF INFORMATION COULD RESULT IN EXPULSION FROM ANY TRAINING, APPRENTICESHIP PROGRAM, OR MEMBERSHIP IN LIUNA LOCAL 1089.
2. THE APPLICANT FURTHER AGREES THAT SHOULD HE OR SHE RECEIVE A JOB PLACEMENT RF MEMBERSHIP, NOT WITHSTANDING THE WAGE RATE PAID FOR A CLASSIFICATION CONTAINED WITHIN A COLLECTIVE AGREEMENT, THAT UPON AN ASSESSMENT MADE IN ACCORDANCE WITH THE PROCEDURES SET BY THE UNION OR THE LOCAL APPRENTICESHIP COMMITTEE, HE OR SHE SHALL FOR THE PURPOSES OF NEEDING ADDITIONAL TRAINING, AGREE TO REGISTER WITH THE MINISTRY OF TRAINING, COLLEGES & UNIVERSITIES (MTCU) AS AN APPRENTICE TO RECEIVE SUCH TRAINING
3. THE APPLICANT AGREES TO BE BOUND TO THE CONSTRUCTION CRAFT WORKER APPRENTICESHIP PROGRAM, ITS RULES AND POLICIES INCLUDING THE PROBATIONARY PERIODS CONTAINED THEREIN IF ACCEPTED FOR EMPLOYMENT OR MEMBERSHIP WITH THE UNION.

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