Illinois Laborers' & Contractors Program

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Great Plains App - Local 996

Local 996

 

Effective November 29, 2021, all apprentices, journeymen, and personnel who work at or enter any Training Program facility will be required to show proof of either being fully vaccinated against COVID-19 or that the first dose of a two-dose vaccine has been administered. Religious and/or medical exemptions can be filled out and submitted for approval. Individuals with approved exemptions will be the only ones eligible for weekly testing. Masks will still be required at each facility for all individuals until otherwise notified.


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If you selected None above for Participation in Other Training Programs, please enter N/A in the box below.
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Applicant's Work Experience

Previous Employer #1
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Date of Employment
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Previous Employer #2
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Date of Employment
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Previous Employer #3
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Date of Employment
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Voluntary Disability Disclosure



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Why are you being asked to complete this form?

Because we are a sponsor of a registered apprenticeship program and participate in the National Registered Apprenticeship System that is regulated by the U.S. Department of Labor, we must reach out to, enroll, and provide equal opportunity in apprenticeship to qualified people with disabilities.[1] To help us learn how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for apprenticeship, any answer you give will be kept private and will not be used against you in any way.

If you already are an apprentice within our registered apprenticeship program, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our apprentices at the time of enrollment, and then remind them yearly, that they may update their information. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.


How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to: blindness, deafness, cancer, diabetes, epilepsy, autism, cerebral palsy, HIV/AIDS, schizophrenia, muscular dystrophy, bipolar disorder, major depression, multiple sclerosis (MS), missing limbs or partially missing limbs, post-traumatic stress disorder (PTSD), obsessive compulsive disorder, impairments requiring the use of a wheelchair, intellectual disability (previously called mental retardation).

[1] Part 30 – Equal Employment Opportunity in Apprenticeship. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Apprenticeship website at https://www.doleta.gov/OA/eeo/.

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