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Members Skills Sheet Form

Be More Employable. Update & Submit Your Skills Sheet

Your Information
Name
First Last
Birthday
Date Format: MM slash DD slash YYYY
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Cell
Email
Do you have a Driver’s license?
- Yes
- No
Do you have a CDL?
- Yes
- No
Class:
Do you have a vehicle in good running condition?
- Yes
- No
List any type of construction job you DO NOT wish to be employed in.
Skills
Check ONLY those skills you have actually performed. Then give the Employer’s name and a BRIEF description of your duties.
- Asphalt
- Asphalt Raker
- Asphalt Screwman
- Bridge
- Burning
- Carpenter
- Carpenter Tender
- Catch Basins
- Concrete
- Concrete Pump
- Concrete Saw
- Conduit
- Demolition
- Fences, Signs & Guardrails
- Finish
- Flag Person
- Form Setter
- Gas Line
- Grade Work
- Jackhammer
- Line Striper
- Miner
- Other (Explain)
- Railroad
- Road Saw
- Sewer Line
- Tack Truck
- Tie Rebar
- Transit
- Tunnel
- Vibrator
- Water Line
- Welder (Certified)
- Welding (Backyard)
Asphalt Employer's Name
Asphalt - Brief description of your duties
Asphalt Raker Employer's Name
Asphalt Raker - Brief description of your duties
Asphalt Screwman Employer's Name
Asphalt Screwman - Brief description of your duties
Bridge Employer's Name
Bridge - Brief description of your duties
Burning Employer's Name
Burning - Brief description of your duties
Carpenter Tender Employer's Name
Carpenter Tender - Brief description of your duties
Catch Basins Employer's Name
Catch Basins - Brief description of your duties
Concrete Employer's Name
Concrete - Brief description of your duties
Concrete Pump Employer's Name
Concrete Pump - Brief description of your duties
Concrete Saw Employer's Name
Concrete Saw - Brief description of your duties
Conduit Employer's Name
Conduit - Brief description of your duties
Fences, Signs & Guardrails Employer's Name
Fences, Signs & Guardrails - Brief description of your duties
Finish Employer's Name
Finish - Brief description of your duties
Flag Person Employer's Name
Flag Person - Brief description of your duties
Form Setter Employer's Name
Form Setter - Brief description of your duties
Gas Line Employer's Name
Gas Line - Brief description of your duties
Grade Work Employer's Name
Grade Work - Brief description of your duties
Jackhammer Employer's Name
Jackhammer - Brief description of your duties
Line Striper Employer's Name
Line Striper - Brief description of your duties
Miner Employer's Name
Miner - Brief description of your duties
Other (Explain) Employer's Name
Other (Explain) - Brief description of your duties
Railroad Employer's Name
Railroad - Brief description of your duties
Road Saw Employer's Name
Road Saw - Brief description of your duties
Sewer Line Employer's Name
Sewer Line - Brief description of your duties
Tack Truck Employer's Name
Tack Truck - Brief description of your duties
Tie Rebar Employer's Name
Tie Rebar - Brief description of your duties
Transit Employer's Name
Transit - Brief description of your duties
Tunnel Employer's Name
Tunnel - Brief description of your duties
Vibrator Employer's Name
Vibrator - Brief description of your duties
Water Line Employer's Name
Water Line - Brief description of your duties
Welder (Certified) Employer's Name
Welder (Certified) - Brief description of your duties
Welding (Backyard) Employer's Name
Welding (Backyard) - Brief description of your duties
List any substances you CANNOT work with:
Check any of the following that apply to you.
- Fear of Confined Spaces
- Fear of heights
- Am able to climb
- Can work in a respirator
Specialized Training
Give certification dates. (This does not include classes you have taken at the Ohio Laborers’ Training School.)
Check all that apply:
- Welding
- OSHA 30
- CDL
- STP
- Traffic Control Supervisor
- Other (Please list other certifications)
Welding Certification Date
Date Format: MM slash DD slash YYYY
OSHA 30 Certification Date
Date Format: MM slash DD slash YYYY
CDL Certification Date
Date Format: MM slash DD slash YYYY
CDL Class
STP Certification Date
Date Format: MM slash DD slash YYYY
Traffic Control Supervisor Certification Date
Date Format: MM slash DD slash YYYY
Other Certification Date
Date Format: MM slash DD slash YYYY
I have read and understand Local 860’s Referral Policy and certify that the above statements are true and correct.
Signature

Address

3334 Prospect Ave.
Cleveland, OH 44115

Phone/Fax

Phone: 216.432.1022
Fax: 216.432.1025

Business Hours

Weekdays: 8:00 am – 3:00 pm

© Copyright Laborers Local Union 860. All rights reserved.

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