BAC 4 IN/KY APPRENTICESHIP & TRAINING PROGRAM PO Box Merrillville, IN

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INSTRUCTIONS FOR APPLICATION & PROCEDURES OF SELECTION AND PLACEMENT OF APPRENTICES BAC 4 IN/KY APPRENTICESHIP & TRAINING PROGRAM PO Box 10935 Merrillville, IN 46411 219-525-4443 bac4apprenticeship@gmail.com Persons desiring to enter the Brick Masons trades may obtain an application from online or at any training center or union hall. (Field Representatives and support staff are not governed by the Joint Apprenticeship and Training Committee.) Application period is open all year. All applications are accepted without regard to race, color, religion, national origin, sex, sexual orientation, age (minimum 18 years of age), genetic information, and/or disability. To be considered for apprenticeship, applicants must comply with the following: 1. Fill out the 6 page application in its entirety 2. Attached the following required documents to the application a. Copy of Diploma or GED * if applicable b. Official Transcript of Grades * if applicable c. Copy of their Birth Certificate d. Enclose Three Hand Signed Letters of References not related to you e. Copy of their Driver s License * If you have not completed High School, you may still be accepted into the program. If accepted, you will be required to obtain your GED within 1 year of your acceptance. Only complete applications will allow applicants to move on to evaluations. RETURNING AN APPLICATION ALL APPLICATIONS MAY BE EMAILED TO: bac4apprenticeship@gmail.com MAILING AN APPLICATION: You have the option of mailing an application to the designated address in your area listed below. The mailing address listed below may not coincide with the chapter area you are applying for, you will still be applying for the chapter closest to your address. State Office Address: BAC 4 IN/KY Apprenticeship & Training Program PO Box 10935 Merrillville, IN 46411 1

BLOOMINGTON TRAINING CENTER *Bloomington Chapter includes Bartholomew, Brown, Dearborn, Decatur, Jackson, Jefferson, Jennings, Lawrence, Monroe, Ohio, Orange, Owen, Ripley, Scott, Switzerland, & Washington counties *Louisville Chapter includes Breckinridge, Bullitt, Carroll, Edmonson, Grayson, Hancock, Hardin, Hart, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, & Tremble KY counties Instructor: TIM JENKINS Phone: 812-287-1914 Email: jenkins-t@att.net Attn: Tim Jenkins Columbus Municipal Airport 2617 Arnold Street Columbus, IN 47203 GRIFFITH TRAINING CENTER * Merrillville Chapter includes Lake, Jasper, Newton, LaPorte, Starke, & Porter counties Instructor: JEFF CAVINDER Attn: Jeff Cavinder Phone: 219-405-6470 940 North Broad Street Email: jethro2465@gmail.com Griffith, IN 46319 INDIANAPOLIS TRAINING CENTER * Indianapolis Chapter includes Boone, Hancock, Hendricks, Johnson, Marion, Montgomery, Morgan, & Shelby counties * Muncie Chapter includes Blackford, Delaware, Fayette, Franklin, Hamilton, Henry, Jay, Madison, Randolph, Rush, Tipton, Union, & Wayne counties * Lafayette Chapter includes Benton, Carroll, Clinton, Fountain, Warren, White, & Tippecanoe counties Instructor: JOE ALBERTS Attn: Joe Alberts Phone: 812-881-0293 8455 Moller Road Email: joealbertsbac@gmail.com Indianapolis, IN 46268 VINCENNES TRAINING CENTER * Evansville Chapter includes Crawford, Dubois, Perry, Posey, Spencer, Vanderburgh, & Warrick IN counties Henderson, Union, Daviess, McClean, & Webster KY counties * Terre Haute Chapter includes Clay, Daviess, Gibson, Greene, Knox, Martin, Parke, Pike, Putnam, Sullivan, Vermillion, & Vigo counties Instructor: KEVIN RUSSELL Phone: 812-287-2121 Email: kevo4321.kr@gmail.com WARSAW TRAINING CENTER Attn: Kevin Russell College of Technology Vincennes University 1002 North First Street Vincennes, IN 47591 * Fort Wayne Chapter includes Allen, Adams, DeKalb, Huntington, Noble, Steuben, Wells, & Whitley counties * South Bend Chapter includes Cass, Elkhart, Fulton, Grant, Howard, Kosciusko, LaGrange, Marshall, Miami, Pulaski, St. Joseph, & Wabash counties Instructor: DAN FLORES Attn: Dan Flores Phone: 574-320-6369 4068 N State Road 15 Email: bac4sbfw@yahoo.com Warsaw, IN 46582 2

DROPPING OFF AN APPLICATION: If you wish to drop off the application you must contact the instructor in your area. The instructor will give an address and office hours that he is available to accept the application. AFTER AN APPLICANT HAS RETURNED AN APPLICATION Once an applicant has returned a complete application the Joint Apprenticeship & Training Committee will periodically review the complete applications and, as openings occur, evaluations that include a hands-on session, math, and ruler test will be conducted along with interviews. Applicants will be placed in order of total scoring and ranked with previous groups who have not been placed in employment. Applicants will be referred to pre-apprentice school in descending order of ranking. The Joint Apprenticeship & Training Committee will, as opportunities arise, provide the opportunity for persons to apply for apprenticeship. The local public employment services, the superintendent of schools, minority organizations, female organizations, the YWCA and the WMCA will be notified of availability of applications. Once accepted, each selected applicant will be assigned to a particular employer. Should a transfer to another employer become necessary due to lack of work, the apprentice will be transferred to another employer at the first opportunity that arises in order to maintain a reasonable expectation of continuity of employment. The Joint Apprenticeship & Training Committee will be informed as to all apprentice(s) transfers. All applicant selection records shall be retained for a period of five years. 3

APPLICATION FOR APPRENTICESHIP TRADE: BRICKLAYER DATE (Please Print) PERSONAL NAME OF APPLICANT FIRST MIDDLE LAST ADDRESS NUMBER/STREET CITY/STATE ZIP PHONE # SS# - - HAVE YOU EVER APPLIED FOR LOCAL 4 IN/KY BRICKLAYERS APPRENTICE PROGRAM BEFORE? NO YES IF YES, WHEN HAVE YOU EVER BEEN CONVICTED OF A FELONY? NO YES IF YES, PLEASE EXPLAIN: ARE YOU PHYSICALLY ABLE TO PERFORM THE FUNCTIONS OF THE JOB? YES NO WILL YOU REQUIRE ANY PHYSICAL OR MENTAL ACCOMMODATIONS TO PERFORM THE FUNCTIONS OF THE JOB? YES NO. IF YES, PLEASE EXPLAIN EMPLOYMENT RECORD DATES NAME OF EMPLOYER FROM TO KIND OF WORK (EXPLAIN) 1

EDUCATION NAME OF HIGH SCHOOL LOCATION GRADUATED DATE OR HIGHEST GRADE COMPLETED * If you have not completed High School, you may still be accepted into the program. If accepted, you will be required to obtain your GED within 1 year of your acceptance. HOBBIES OTHER TRAINING(CORRESPONDENCE, NIGHT, TRADE SCHOOL, MILITARY COURSES,ETC ) WHY DO YOU WANT TO BECOME AN APPRENTICE IN THIS TRADE? USE THIS SPACE FOR ANY OTHER INFORMATION WHICH YOU THINK MAY BE PERTINENT. REFERENCES ATTACHED THREE HAND SIGNED LETTERS OF REFERENCE, PERSONS NOT RELATED TO THE APPLICANT 2

AN ACCEPTANCE OF AN APPLICANT INTO THIS PROGRAM IS SUBJECT TO THE APPLICANT S PASSAGE OF THIS PROGRAM S THEN CURRENT DRUG AND ALCOHOL TESTING REQUIREMENTS. YOU WILL NOT BE PERMITTED TO ENTER/START YOUR TRAINING WITHOUT MEETING THIS PRE-ADMISSION REQUIREMENT. ADDITIONALLY, AN APPRENTICE S CONTINUED PARTICIPATION IN THIS PROGRAM WILL REQUIRE THE APPRENTICE TO ACCEPT RANDOM DRUG AND ALCOHOL TESTING AND WILL REQUIRE THE APPRENTICE S PASSAGE OF SUCH TESTS. ALL THE ABOVE INFORMATION IS CORRECT AND ACCEPTED BY: APPLICANT S SIGNATURE DATE APPLICATION CHECKLIST Include all the following to return a complete application: o Completed Application o Copy of Diploma or GED * if applicable o Official Transcript of Grades * if applicable o Copy of their Birth Certificate o Enclose Three Hand Signed Letters of References not related to you o Copy of their Driver s License * If you have not completed High School, you may still be accepted into the program. If accepted, you will be required to obtain your GED within 1 year of your acceptance. 3

BAC 4 IN/KY APPRENTICESHIP & TRAINING PROGRAM PO BOX 10935 Merrillville, IN 46411 Office: 219-525-4443 Roger Jones, Managing Director REFERRAL SLIP TO BE USED ONCE ACCEPTED IN TO THE PROGRAM THE TRUSTEES OF THIS FUND, HEREBY REFER, AN APPRENTICE APPLICANT, TO A DESIGNATED COLLECTION SITE FOR A DRUG AND ALCOHOL TEST. THIS TEST MUST BE TAKEN AT THE TIME DESIGNATED BY THE MANAGING DIRECTOR. THE APPRENTICE APPLICANT S FAILURE TO TAKE THE REQUIRED TEST WITHIN THE DESIGNATED TIME AUTO-MATICALLY RESULTS IN THE APPRENTICE APPLICANT S REJECTION FROM THE PROGRAM. A RANDOM TESTING WILL BE CONDUCTED DURING YOUR PRE-APPRENTICE CLASSES. THE APPRENTICE APPLICANT S FAILURE TO PASS THE REQUIRED TESTINGS WILL RESULT IN THE AUTOMATIC REJECTION OF THE APPLICANT. AFTER AN APPLICANT IS REJECTED FOR FAILURE TO TAKE THE REQUIRED DRUG TEST OR FAILURE TO PASS THE REQUIRED DRUG TEST AN APPLICANT MUST WAIT THE MINIMUM OF ONE YEAR AFTER THE DATE OF THE DESIGNATED DRUG TEST TO REAPPLY. THE APPRENTICE APPLICANT AGREES THAT THE TEST RESULTS WILL BE SENT TO ROGER JONES, MANAGING DIRECTOR. THE FOLLOWING IS AGREED TO BY:.. APPRENTICE APPLICANT SIGNATURE DATE #XXX-XX-. SOCIAL SECURITY NUMBER (LAST 4 # S) #. DRIVERS LICENSE NUMBER 4

COMPLAINT PROCEDURE TITLE 29 CFR 30.14 Any apprentice or applicant for apprenticeship who believes that he or she has been discriminated against on the basis of on race, color, religion, national origin, sex, sexual Orientation, age (40 or older), genetic information, and/or disability with regard to apprenticeship, or that the equal opportunity standards with respect to his or her selection have not been followed in the operation of an apprenticeship program, may personally or through an authorized representative, file a complaint with the department of labor. The complaint must be filed not later than 300 days from the date of the alleged discrimination or specified failure to follow the equal opportunity standards. The complaint shall be in writing and shall be signed by the complainant. It must include the name, address and telephone number of the person allegedly discriminated against, the program sponsor involved, and a brief description of the circumstances of the failure to apply the equal opportunity standards. I CERTIFY THAT I HAVE RECEIVED A COPY OF THE COMPLAINT PROCEDURES IN ACCORDANCE WITH TITLE 29 CFR 30.14 SIGNATURE DATE 5

AFFIRMATIVE ACTION INFORMATION FORM The following information is being requested to comply with government regulations. The requested information is for affirmative action statistical purposes only and will not be kept with your application. Please answer all 4 categories. 1. Gender [ ] Male [ ] Female [ ] I do not wish to disclose 2. Race [ ] American Indian or Alaskan Native [ ] Asian [ ] Black or African American [ ] Native Hawaiian or other Pacific Islander [ ] White [ ] I do not wish to disclose 3. Ethnic Group [ ] Hispanic or Latino [ ] Non-Hispanic or Latino [ ] I do not wish to disclose 4. Disability [ ] Yes, I have a Disability (or previously had a disability) [ ] No, I don t have a Disability [ ] I do not wish to disclose SIGNATURE DATE 6