The Information request herein is a voluntary disclosure and is used for Apprentice Program Statistical Purposes and will only be disclosed in accordance with the provisions of the Privacy Act (Privacy Act 0f 1974- P.L - 93-579)

This organization does not require a pre-acceptance medical examination, but the contractor members of this organization do reserve the right to require drug testing and/or a medical examination after an offer of employment is made to an applicant. Offers of employment are conditioned upon the passing of a drug test for the purpose of detecting the illegal use of drugs. Also, if an employment offer is made, you may be asked to answer certain medical questions. An applicant will not be excluded from employment unless they have medical conditions that prohibit their ability to perform the essential job functions of electrical apprentice, with or without reasonable accommodations.

Read the following conditions. If you have any questions regarding the conditions, you should ask for a full explanation or clarification from the IEC office (219-900-0091). Signify your understanding and specific acceptance of each condition by your signature in the space provided at the end of this form.

I hereby authorize the Independent Electrical Contractors Association to investigate any and all statements contained in this application. I hereby consent to the IEC Association conducting any checks concerning by background which are deemed necessary, advisable or helpful by the IEC Association (except contracting my current employer, unless permission is granted above). I understand that failure to produce a valid driver’s license and a clean driving record will not prohibit my acceptance into the program but may limit the ability of the IEC to place me with a member. I may be required to submit to a drug test. I hereby consent to a drug test and waive any and all objections I might otherwise have to such a drug test. I understand that all statements made this application are true and complete to the best of my knowledge and without mental reservations. I understand that falsification of this application may result in my not being considered for acceptance or, in the event that I am accepted by the Independent Electrical Contractors Association, in my dismissal from the program.

‍