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IBEW Local 86
Rochester NY
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Referral
** Job Calls & Announcements **
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Referral procedure
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I.B.E.W. Local 86 Rochester, NY Electrician Application
This application is not for the Apprenticeship. If you wish to apply for the Apprenticeship please contact the training center at (585) 235-5050.
Please enable JavaScript in your browser to complete this form.
–
Step
1
of 4
Name
*
First
Middle
Last
Phone
*
Email
*
Date of birth
*
Last 4 Social Security Number
*
Address
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
How did you hear about I.B.E.W.?
Word of Mouth/Personal Recommendation
Internet/Social Media
Physical Advertisement i.e. Billboard, Newspaper
Next
Are you a High School graduate?
*
Yes
No
Do you have a "GED"?
Yes
No
Did you ever participate in any kind of vocational technical training during or after high school?
*
Yes
No
How long was the program?
Describe the program
Did you complete the program?
Yes
No
Have you served in the US military?
*
Yes
No
How long did you serve?
Which branch did you serve?
Did you complete any military training schools?
Do you have a valid Driver's License?
*
Yes
No
Do you have a CDL?
*
Yes
No
What class CDL do you have?
*
Class A
Class B
Class C
https://www.dmv.org/commercial-drivers/cdl-class-types.php
Do you have an OSHA 10 hour card?
*
Yes
No
Are you physically and mentally able to safely perform or learn to perform the work of this trade, either with or without reasonable accomodations?
*
Yes
No
Are you able to get to and from work at various job sites anywhere within the geographical area?
*
Yes
No
Are you able and willing to attend all related classroom training as required?
*
Yes
No
Are you able to climb and work from ladders, scaffolds, poles or towers of various lengths and heights?
*
Yes
No
Can you crawl and work in confined spaces such as attics, manholes and crawl spaces?
*
Yes
No
Are you able to hear and understand verbal instructions and warnings given in English?
*
Yes
No
Do you have the legal right to work in the United States?
*
Yes
No
Next
Employment Information
Do you have electrical or construction work experience?
*
Yes
No
Months/Years of Experience?
List the Contractors you have worked for.
Are you presently employed?
*
Yes
No
Present or Most Recent Employer
*
Employer Address
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Type of work
*
Industrial
Commercial
Residential
Other
Describe "other" type of work
Owner
Immediate Supervisor
*
Number of employees working for this Employer
Employment start date
*
Employment end date (if one)
Salary
Benefits
May we contact this employer?
*
Yes
No
Next
I understand all the above and state that, to the best of my knowledge, all information provided on this form is true and accurate.
*
Yes
Initial (First and Last)
*
Date
*
Website
Submit
