SOUTHEASTERN CARPENTERS REGIONAL COUNCIL

COUNCIL REPRESENTATIVE CANDIDATE QUESTIONNAIRE

Interview Date:

Local Union No.(Required)

Candidate Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Email Address(Required)

Enter Email Confirm Email

Your Phone(Required)

UBC #(Required)

Please answer the following questions.

When did you join the Brotherhood?

Did you go through the apprenticeship?

Yes

No

Year completed:

Highest grade of education:

(include any college)

Have you ever served on any boards, advisory committees, or any other public or private committees?

Are you computer literate? If so, list all programs you have used:

Do you have any prior business experience? If so, give a brief history of experience:

Do you have any experience in directing, coordinating and administering to employees? If so, explain:

Do you drive an American made car?

Do you have a current driver's license?

Yes

No

Do you understand that a background check will be made on you before employment begins?

Yes

No

Disclaimer Regarding Prohibition on Certain Persons Holding Union Office

Section 504 of the Labor-Management Reporting and Disclosure Act (“LMRDA”) prohibits individuals convicted of certain crimes from holding union office, being employed by a union, or serving in certain other prohibited capacities. If an individual has been convicted of certain crimes, including murder, assault with intent to kill, assault that inflicts grievous bodily injury, rape, arson, extortion, burglary, grand larceny, robbery, bribery, embezzlement, violation of narcotics laws, conspiracy or attempt to commit any of the above, or similar crimes then they are prohibited from holding office for 13 years from the date of conviction or completion of any term of imprisonment, whichever is later.

If you have any questions, please contact the Council. For more information, please visit: https://www.dol.gov/agencies/olms/compliance-assistance/publications/prohibition-against-certain-persons-holding-union-office-or-employment

I hereby acknowledge that I have read and understand the above regarding Section 504 of the LMRDA. I swear that the answers provided in the application are true, and that I understand the questions asked. Entering my name and the date below will be considered an electronic signature:

Name

Date

Council Representative
Writing Skills

Briefly describe what you feel should be the long-term goals for Southeastern Carpenters Regional Council:

DISCLOSURE REGARDING CONSUMER REPORTS

SOUTHEASTERN CARPENTERS REGIONAL COUNCIL
3710 EXECUTIVE CENTER DRIVE, SUITE A
706-854-8777

Southeastern Carpenters Regional Council Will Obtain a Background Check
You acknowledge and understand that in connection with your application for employment with Southeastern Carpenters Regional Council> (including any independent contract for services) or when deciding whether to modify or continue your ongoing employment, if hired, we may obtain a “consumer report” and/or an “investigative consumer report” on you from Trak-1, a consumer reporting agency, or from any third party, in strict compliance with both state and federal law.

Consumer Report Defined
A consumer report is any communication of information by a consumer reporting agency bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living which is used or expected to be used for purposes of serving as a factor in establishing your current and/or continuing eligibility for employment purposes. A common term for a consumer report is a “background check report.”

Investigative Consumer Report Defined
An investigative consumer report is obtained through personal interviews with individuals who may have knowledge of your character, general reputation, personal characteristics, or mode of living. An investigative consumer report might include, for example, calls to the personal references you provide or conversations with former supervisors or colleagues where you worked.

Reports May Contain
The consumer reports or investigative consumer reports may contain public record information which may be requested or made on you including, but not limited to: consumer credit, criminal records, civil cases in which you have been involved, driving history records, current motor vehicle insurance coverage information, education records, previous employment history, workers compensation claims history, social security traces, military records, professional licensure records, eviction records, drug testing, government records, and others.

You further understand that these reports may include experience information along with reasons for termination of past employment. You also acknowledge and understand that information from various federal, state, local and other agencies which contain information about your past activities will be requested, and that a consumer report containing injury and illness, drug testing, or other medical records and medical information may be obtained only after a tentative offer of employment has been made.

Your Rights as a Consumer
You are hereby notified that you have the right to make a timely request for a copy of the scope and nature of the above investigative background report and/or a complete copy of your consumer report contained in Trak-1’s files on you at the time of your request by providing proper identification.

You are further notified that, prior to being denied employment based in whole or in part on information obtained in the consumer report, you will be provided a copy of the report, the name, address and telephone number of the consumer reporting agency and a description in writing of your rights under the Fair Credit Reporting Act. Correspondence to Trak-1 should be forwarded to:

Trak-1 | Consumer Relations | 7131 Riverside Parkway | Tulsa, OK 74136
1-800-600-8999 | CustomerCare@Trak-1.com

AUTHORIZATION TO OBTAIN CONSUMER REPORT

For consideration as a candidate, you will be required to download and submit a completed copy of this Authorization to Obtain Consumer Report: authorization.pdf.

The completed authorization form must be submitted to Amy Wills at awills@secarpenters.org, or by mail to:

3710 Executive Center Dr., STE-A
Augusta, GA 30907

Acknowledgement of Consumer Report Authorization(Required)

I confirm that I have downloaded the consumer report authorization file, and understand that I need to submit it to Amy Wills via email or mail at one of the addresses listed above.

I have downloaded the authorization form