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Pipefitters Local Union 211 Application Form
*
Application Type?
Pipefitter
Welder
I understand that any false statement is just cause for cancellation of membership.
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First Name
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Middle Name
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Last Name
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Address
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City
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State
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Zip
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Email Address
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Date of Birth
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Home Phone
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Cell Phone
*
Cell Phone Provider
EMPLOYMENT BACKGROUND:
YOU MUST COMPLETE THE ENTIRE APPLICATION (INCLUDING JOB HISTORY) TO BE CONSIDERED FOR EMPLOYMENT.
Company 1
Foreman/Supervisor 1
Foreman/Supervisor Phone# 1
Years Employed 1
Months Employed 1
Company 2
Foreman/Supervisor 2
Foreman/Supervisor Phone# 2
Years Employed 2
Months Employed 2
Company 3
Foreman/Supervisor 3
Foreman/Supervisor Phone# 3
Years Employed 3
Months Employed 3
Emergency Contact:
*
EC Name
*
EC Relationship
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EC Phone Number(s)
Beneficiary of Burial Benefits:
*
BBB Name
*
BBB Relationship
*
BBB Address
*
BBB Phone Number
*
Have you ever been a member of a Union before?
Yes
No
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Are you a U.S. Citizen?
Yes
No
*
Are you a Veteran?
Yes
No
Check ALL skills that you perform and can provide documentation of proof for:
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Pipefitter
Braze Copper
CAD/Drafting
Detailer
Estimator
Fabrication
Fitter (Commercial)
Fitter (Industrial)
Fitter (Shop)
Instrument Tech
Instrument Fitter
Rigging Qualification
Rigging Certs
Read Blueprints
Lay Out
Pneumatic (courier tube)
ProPress
PVC
Screwpipe
Sweat Copper
Tubing
Valve Tech
Victaulic
Structural Fitter
STAR (PF)
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Service
A/C Service
Air Balance
Centrifugal
Chiller Mechanic
Building Automation
HVAC License
HVAC Commercial
HVAC Industrial
HVAC Maintenance
HVAC Residential
Ice Machines
Pump Alignment
R-410A Cert
Refrigeration
Split-Systems
Start-Up
State Regis.
Universal EPA
Ammonia
*
Welder
Uphill Stick (6010/7018)
Downhill Stick (6010)
TIG (Carbon Steel)
TIG (Stainless Steel)
TIG (Fusion Weld)
TIG & Stick (Combo Test)
Hot Welds
J-Prep Heavy Wall
AWS Cert
MIG (Standard)
MIG (RMD/STT)
MIG (Pulsed)
Flux-Core
Orbital Welding
Pipe Welder (Comm.)
Pipe Welder (Ind.)
Pipe Welder (Shop)
Structural Only
Tacker (MIG, TIG, STICK)
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Miscellaneous
Copper Tested
Bilingual
Clean Room
Foreman
General Foreman
Helper
Industrial
Inspection
HASC-ISC
HASC-NCCER
HASC-Basic Plus
HASC-Safety
HASC-Rigging
Nuke
OSHA 10
OSHA 30
Pipe Yard
Shop Foreman
Superintendent
Project Mgr.
TWIC
Brazing Certs
How many years/months of working experience do you have in the Piping Industry ONLY?
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Piping Industry experience years:
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Piping Industry experience months:
How many years/months of working experience do you have in the Structural Industry ONLY?
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Structural Industry experience years:
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Structural Industry experience months:
How many years/months of HVAC or Service Experience?
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HVAC or Service experience years:
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HVAC or Service experience months:
How many years/months of Instrument & Electrical Experience?
*
Instrument & Electrical experience years:
*
Instrument & Electrical experience months:
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Do you have a resume?
Yes
No
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Can you pass a background check?
Yes
No
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Have you ever been convicted of a felony?
Yes
No
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Are you on probation?
Yes
No
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Can you pass a drug screening?
Yes
No
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Would you be willing to learn more skills?
Yes
No
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Would you be willing to test or have a skill level evaluation?
Yes
No
*
Comments or other info:
*
How did you hear about us?
Background Check Authorization
*
First Name
*
Middle Name 1
Last Name 2
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Former Names Used
*
Current Address
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City
*
State
*
Zip
*
DOB
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Telephone Number
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Drivers License Number/State
