Pre Apprentice – Application Request – Crater Lake Electrical Training Center

Name(Required)

First Last

Previous Name (if applicable)

Please provide the name that will appear on documents or transcripts if it is different from your present name.

Phone(Required)

Area Code & Number

Email(Required)

County of Residence(Required)

Select from the drop down menu which county you currently reside in

Date of Birth(Required)

Gender(Required)

Veteran Status(Required)

Active Military

Veteran

Non Veteran

Education History(Required)

Currently in High School

Did Not Graduate High School

GED

High School Diploma

Completed Tech School

Some College

Associate's Degree

Bachelor's Degree

Select the highest level of education you have achieved.

High School(Required)

List the High School you are currently attending below

Household Income(Required)

Does your household fall below 185% of the Federal Poverty Guideline? Visit: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines to see if you qualify. Find the poverty guideline associated with the number of family members in your household. Divide your income by the poverty guideline listed for your household size. Carry the decimal places to the right and add a percentage sign. If your percentage is less than 185% of the poverty guideline, mark yes on the next question. *NOTE: at a later date you will need to submit your calculations from the instructions above and one of the following: (1) - [2021 State, Federal, or Tribal tax return], (2) - [Federal or Tribal notice letter of participation in General Assistance], or (3) - [SNAP card or a letter verifying SNAP eligibility]

Yes

Undetermined

Disability Status(Required)

Disabled

Non Disabled

Decline to Disclose

Ethnicity(Required)

Hispanic or LatinX

Non Hispanic

Race(Required)

American Indian/Alaska Native

Asian

Black/African American

Caucasian

Native Hawaiian/Pacific Islander

Other

Hidden

Criminal History(Required)

Have you ever been convicted of a crime that resulted in an incarceration? Knowing this will help us provide you special programs that are available **Crater Lake Electrical JATC & Training Trust does not discriminate against individuals based on their criminal record or other protected characteristics.

Yes

Currently Incarcerated

Do You Have Any Electrical Apprenticeship Experience?(Required)

Yes

When and Where?

List the Contractor(s) that you work/worked for as well as any Apprenticeship Programs you have participated in.

Explain why you would be a good candidate for a registered pre-apprenticeship program?(Required)

Identify your skills, interests, & accomplishments in 500 characters or less.

What are your long-term goals? How will this pre-apprenticeship program help you meet these goals?(Required)

500 Characters or less.

How Did You Hear About Our Program(Required)

High School Teacher/Counselor/Etc

Worksource Center

IBEW Local 659

Web Search

Friend

Other

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Name

This field is for validation purposes and should be left unchanged.

Apply for the Rogue Pre-Apprenticeship Program

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