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<tr class="odd">
<td colspan="3" rowspan="8"><p>OMB Approval</p>
<p>#1910-1100</p>
<p>07/04</p>
<p><strong>United States Department of Energy</strong></p>
<p><strong>Bonneville Power Administration</strong></p>
<p><strong>Supplemental Questionnaire for all</strong></p>
<h5 id="electrical-apprenticeships">Electrical Apprenticeships</h5></td>
<td rowspan="8"></td>
<td colspan="10"><strong>     </strong></td>
<td></td>
<td colspan="3">     </td>
</tr>
<tr class="even">
<td colspan="10"><strong>Name</strong></td>
<td></td>
<td colspan="3"><strong>Social Security Number</strong></td>
</tr>
<tr class="odd">
<td colspan="14"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="14"><strong>Street Address/P.O. Box</strong></td>
</tr>
<tr class="odd">
<td colspan="12"><strong>     </strong></td>
<td></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="12"><strong>City/State</strong></td>
<td></td>
<td><strong>Zip Code</strong></td>
</tr>
<tr class="odd">
<td colspan="4"><strong>     </strong></td>
<td></td>
<td><strong>     </strong></td>
<td></td>
<td colspan="7"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="4"><strong>Telephone</strong> <em>(Day)</em></td>
<td></td>
<td><em>(Evening/Cellular)</em></td>
<td></td>
<td colspan="7"><strong>Electronic-mail address</strong></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="16"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="4" rowspan="2"><strong>Please check the box(s) for all
electrical apprenticeship positions for which you are
applying:</strong></td>
<td></td>
<td></td>
<td colspan="5"><strong>Apprentice Electrician</strong></td>
<td></td>
<td colspan="5"><strong>Apprentice Substation Operator</strong></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td colspan="5"><strong>Apprentice Lineman</strong></td>
<td></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td colspan="18"></td>
</tr>
</tbody>
</table>

**Applicant Foreword:** The completion of this supplemental
questionnaire is [mandatory]{.underline}. The information requested is
needed to evaluate your relative ability to perform the duties of an
electrical apprentice. Please fully complete the entire questionnaire
answering each question completely and accurately. Your responses must
reflect your actual knowledge and skills. [If completing the question
electronically, it is recommended that you do NOT use all capital
letters since this will significantly reduce the amount of space
available for you to record your answers]{.underline}.

**Drug and Alcohol Testing Notice**: In accordance with DOE Order
3792.3, this position is subject to random drug testing. If offered a
position, you will be tested for the use of illegal drugs prior to
beginning work, and are subject to periodic unannounced random drug
testing while employed. A determination of illegal drug use will result
in non-selection and withdrawal of an employment offer, based upon your
failure to meet a condition of employment. While employed, failure to
pass a random or post-accident drug test may result in disciplinary
action, up to and including removal from the Federal Service. If the
position you are selected for requires the operation of equipment
requiring a commercial driver's license (CDL), you are subject to random
alcohol testing under Department of Transportation regulations.

**Privacy Act Information**: The Bonneville Power Administration is
authorized to evaluate applicants for Federal jobs under the provisions
of Title 5, United States Code, chapter 11, sections 1104, 1302, 3301,
and 3304. The information you provide will be used to determine your
qualifications for these positions. If you do not complete the
information listed, [we will be unable to rate your
application]{.underline}, and you will [not]{.underline} be considered
for these positions. Your Social Security Number is required to keep
your records straight as other people may have the same name and
birthday.

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| p |   |                            |   |   |                               |
| o |   |                            |   |   |                               |
| s |   |                            |   |   |                               |
| i |   |                            |   |   |                               |
| t |   |                            |   |   |                               |
| i |   |                            |   |   |                               |
| o |   |                            |   |   |                               |
| n |   |                            |   |   |                               |
| s |   |                            |   |   |                               |
| . |   |                            |   |   |                               |
| * |   |                            |   |   |                               |
+---+---+----------------------------+---+---+-------------------------------+
| * | * | **Work Condition**         | # | * | **Working Condition**         |
| * | * |                            | # | * |                               |
| Y | N |                            | # | N |                               |
| e | o |                            | # | o |                               |
| s | * |                            |   | * |                               |
| * | * |                            | Y | * |                               |
| * |   |                            | e |   |                               |
|   |   |                            | s |   |                               |
+---+---+----------------------------+---+---+-------------------------------+
|   |   | Work with frequent         |   |   | Work from high places (15     |
|   |   | overnight travel (11 or    |   |   | feet and above)               |
|   |   | more nights per month)     |   |   |                               |
+---+---+----------------------------+---+---+-------------------------------+
|   |   | Work when subject to       |   |   | Work around hazardous         |
|   |   | emergency call-outs (i.e., |   |   | materials (i.e., solvents,    |
|   |   | call to perform emergency  |   |   | PCB\'s, chemicals, etc.)      |
|   |   | work outside normal        |   |   |                               |
|   |   | working hours)             |   |   |                               |
+---+---+----------------------------+---+---+-------------------------------+
|   |   | Work extended periods of   |   |   | Work around                   |
|   |   | overtime, including        |   |   | herbicides/pesticides         |
|   |   | working weekends.          |   |   |                               |
+---+---+----------------------------+---+---+-------------------------------+
|   |   | Work under varying         |   |   | Work with a team or as a      |
|   |   | climatic (rain, snow, ice, |   |   | member of a crew              |
|   |   | high winds, etc.)          |   |   |                               |
|   |   | conditions                 |   |   |                               |
+---+---+----------------------------+---+---+-------------------------------+
|   |   | Work around energized high |   |   | Work in close and confined    |
|   |   | voltage (above 12.5kv)     |   |   | places                        |
|   |   | equipment.                 |   |   |                               |
+---+---+----------------------------+---+---+-------------------------------+
|   |   | Work around moving         |   |   | Work with respirator or full  |
|   |   | machinery                  |   |   | face mask                     |
+---+---+----------------------------+---+---+-------------------------------+
|   |   | Work from ladders and      |   |   | Work alone in isolated        |
|   |   | scaffolds                  |   |   | locations                     |
+---+---+----------------------------+---+---+-------------------------------+

  ----------------------------------------- -- ----------------------------
                                                    

                                               Name
  ----------------------------------------- -- ----------------------------

**[Instructions]{.underline}**

This form will be used to collect information pertaining to your
knowledge, skill, and ability for some of the job elements for the
position(s) for which you are applying. The intent of the questionnaire
is *not* to measure your ability to write; therefore, if a question can
be answered with a simple "Yes" or "No," you should do so. If you
answer, "Yes," you will be asked to write a short descriptive
explanation. If you fail to provide an explanation for an answer you
will not receive credit for the response. If you use pen and ink to
complete the questionnaire, be sure that your responses are legible.
Each question should be completed separately, so DO NOT \"ditto marks\"
or references to answers in other questions. If you need more space to
complete an answer, indicated continued on *page 8*, and use the space
provided to complete your answer. You're advised that statements made on
your resume, application, and this form are be subject to verification
by contact with former employers.

\"WHEN\" can be answered by month and year, e.g., October 1968, or if
covering several years for example, by \"09/68 - 10/72.\"

\"HOW MANY HOURS\" OR \"HOW OFTEN\" can be answered, for example, by
writing \"full-time," or the total approximate number of hours, weeks or
months spent performing the particular activity.

\"WHO FOR,\" \"WHAT COMPANY,\" OR \"WHERE\" can be answered by name of
school attended, company, or employer, or \"at home\" or \"self.\"

\"PURPOSE,\" \"METHOD,\" \"HOW,\" etc., can be answered sometimes by
very few words, such as \"used broom to sweep out work area.\"

+-----------------------------------------------------------------------+
| ######## Disqualifying Driving Records                                |
|                                                                       |
| Within the past **[THREE]{.underline}** years, any of the following   |
| conditions ***disqualify*** an applicant for a U. S. Government Motor |
| Vehicle Authorization and the position(s) for which you are applying: |
|                                                                       |
| 1.  Conviction for operating a motor vehicle under the influence of   |
|     alcohol or a controlled substance.                                |
|                                                                       |
| 2.  Conviction for leaving the scene of an accident without making    |
|     his or her identity known.                                        |
|                                                                       |
| 3.  Driver license suspended, revoked, or canceled.                   |
|                                                                       |
| 4.  Any recurrent record of auto accidents/incidents, traffic         |
|     violations, or arrests, which demonstrates that the employee does |
|     not have an adequate sense of responsibility. This may be shown   |
|     by any of the following:                                          |
|                                                                       |
|     -   Conviction for fleeing or attempting to elude a police        |
|         officer.                                                      |
|                                                                       |
|     -   Conviction for a felony involving the use of a motor vehicle. |
|                                                                       |
|     -   Two or more accidents in which the applicant was at fault.    |
|                                                                       |
|     -   Two or more excessive speeding violations (15 miles per hour  |
|         or more over the posted limit.)                               |
|                                                                       |
|     -   Four or more moving violations                                |
+-----------------------------------------------------------------------+

  ----------------------------------------------------------------------------------------------------
                                                                            **     **
  ---------------- ---------------- --------- -------- -------------------- --------------------------
                                                                            Name

  **Element 2 --                                                            
  Ability to                                                                
  Follow                                                                    
  Instructions**                                                            

  **Questions**                     **Yes**   **No**   **Briefly describe   
                                                       the task (i.e., what 
                                                       you were doing); how 
                                                       you received your    
                                                       instructions         
                                                       (verbal, visual, or  
                                                       written) OR type of  
                                                       equipment you were   
                                                       using** *(Questions  
                                                       1 through 9)*        

  1\.              Have you ever                                            
                   operated                                                 
                   equipment, which                                         
                   required that                                            
                   you perform                                              
                   functions in a                                           
                   precise                                                  
                   sequence?                                                

                                                                            

  2\.              Have you ever                                            
                   participated in                                          
                   a work or other                                          
                   activity where                                           
                   the use of                                               
                   specialized                                              
                   terminology was                                          
                   required?                                                

  3\.              Have you been                                            
                   responsible for                                          
                   cleaning and                                             
                   maintaining                                              
                   tools or shop                                            
                   equipment?                                               

  4\.              Have you ever                                            
                   participated in                                          
                   any activity                                             
                   that required                                            
                   you to perform a                                         
                   sequence of                                              
                   tasks as                                                 
                   directed by                                              
                   another                                                  
                   individual or                                            
                   entity?                                                  

  5\.              Have you                                                 
                   performed                                                
                   inventory or                                             
                   been responsible                                         
                   for supply                                               
                   stock?                                                   

  6\.              Have you had to                                          
                   perform detailed                                         
                   planning and                                             
                   investigation to                                         
                   complete a job                                           
                   or other                                                 
                   activity?                                                
  ----------------------------------------------------------------------------------------------------

  --------------- ---------------- --------- -------- -------------------- --------------------------
                                                                           **     **

                                                                           **Name**

  **Element 2 --                                                           
  Ability to                                                               
  Follow                                                                   
  Instructions                                                             
  (Continued)**                                                            

  **Questions**                    **Yes**   **No**   **Briefly describe   
                                                      the task (i.e., what 
                                                      you were doing); how 
                                                      you received your    
                                                      instructions         
                                                      (verbal, visual, or  
                                                      written) OR type of  
                                                      equipment you were   
                                                      using** *(Questions  
                                                      1 through 9)*        

  7\.             Have you                                                 
                  performed                                                
                  equipment                                                
                  inspection tasks                                         
                  that included                                            
                  reading gauges,                                          
                  meters, or                                               
                  dials?                                                   

                                                                           

  8\.             Have you been                                            
                  responsible for                                          
                  compiling and                                            
                  maintaining                                              
                  records?                                                 

  9\.             Have you used                                            
                  instruction                                              
                  books or manuals                                         
                  to complete                                              
                  tasks?                                                   
  --------------- ---------------- --------- -------- -------------------- --------------------------

  ------ ---------------- --------- -------- -----------------------------------------------
         **Question**     **Yes**   **No**   **Briefly describe the curriculum and the
                                             approximate number of hours completed.**

  10\.   Did you                                  
         satisfactorily                      
         complete a                          
         technical school                    
         (e.g., military,                    
         lineman, etc.)                      
         or vocational                       
         high school                         
         curriculum? If                      
         so, describe the                    
         program or                          
         curriculum.                         

  11\.   Have you had                             
         training in                         
         other technical                     
         areas such as in                    
         the military,                       
         private                             
         contractor, etc?                    
         If so, describe                     
         the type of                         
         training                            
         received.                           
  ------ ---------------- --------- -------- -----------------------------------------------

+---+---------------------+---+---+--------------+--------------------------+
|   |                     |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+
|   |                     |   |   |              | ### Name                 |
+---+---------------------+---+---+--------------+--------------------------+
| * |                     |   |   |              |                          |
| * |                     |   |   |              |                          |
| E |                     |   |   |              |                          |
| l |                     |   |   |              |                          |
| e |                     |   |   |              |                          |
| m |                     |   |   |              |                          |
| e |                     |   |   |              |                          |
| n |                     |   |   |              |                          |
| t |                     |   |   |              |                          |
| 3 |                     |   |   |              |                          |
| - |                     |   |   |              |                          |
| - |                     |   |   |              |                          |
| D |                     |   |   |              |                          |
| e |                     |   |   |              |                          |
| x |                     |   |   |              |                          |
| t |                     |   |   |              |                          |
| e |                     |   |   |              |                          |
| r |                     |   |   |              |                          |
| i |                     |   |   |              |                          |
| t |                     |   |   |              |                          |
| y |                     |   |   |              |                          |
| a |                     |   |   |              |                          |
| n |                     |   |   |              |                          |
| d |                     |   |   |              |                          |
| S |                     |   |   |              |                          |
| a |                     |   |   |              |                          |
| f |                     |   |   |              |                          |
| e |                     |   |   |              |                          |
| t |                     |   |   |              |                          |
| y |                     |   |   |              |                          |
| * |                     |   |   |              |                          |
| * |                     |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+
| * |                     | * | * | **D          |                          |
| * |                     | * | * | escription** |                          |
| Q |                     | Y | N |              |                          |
| u |                     | e | o |              |                          |
| e |                     | s | * |              |                          |
| s |                     | * | * |              |                          |
| t |                     | * |   |              |                          |
| i |                     |   |   |              |                          |
| o |                     |   |   |              |                          |
| n |                     |   |   |              |                          |
| * |                     |   |   |              |                          |
| * |                     |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+
| 1 | Have you worked for |   |   |              |                          |
| . | an employer with an |   |   |              |                          |
|   | established formal  |   |   |              |                          |
|   | safety program      |   |   |              |                          |
|   | (i.e., published    |   |   |              |                          |
|   | safety manuals,     |   |   |              |                          |
|   | procedures, etc.)?  |   |   |              |                          |
|   | If so, please       |   |   |              |                          |
|   | briefly describe    |   |   |              |                          |
|   | the program.        |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+
| 2 | Have you ever       |   |   |              |                          |
| \ | received an award   |   |   |              |                          |
| . | or other            |   |   |              |                          |
|   | recognition for     |   |   |              |                          |
|   | your ability to     |   |   |              |                          |
|   | work safely?        |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+
| 3 | Have you had any    |   |   |              |                          |
| \ | safety related      |   |   |              |                          |
| . | training (CPR,      |   |   |              |                          |
|   | first aid, work     |   |   |              |                          |
|   | procedures, etc.).  |   |   |              |                          |
|   | If so, please       |   |   |              |                          |
|   | describe the type   |   |   |              |                          |
|   | of training,        |   |   |              |                          |
|   | approximate dates,  |   |   |              |                          |
|   | and number of       |   |   |              |                          |
|   | hours.              |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+
| 4 | Have you, in the    |   |   |              |                          |
| \ | last 5 years, had   |   |   |              |                          |
| . | an on-the-job       |   |   |              |                          |
|   | accident or injury, |   |   |              |                          |
|   | which resulted in   |   |   |              |                          |
|   | you missing work or |   |   |              |                          |
|   | school? If so, give |   |   |              |                          |
|   | dates of            |   |   |              |                          |
|   | ac                  |   |   |              |                          |
|   | cident(s)/injuries, |   |   |              |                          |
|   | details of the      |   |   |              |                          |
|   | circumstances that  |   |   |              |                          |
|   | caused the          |   |   |              |                          |
|   | accident/injury.    |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+
| 5 | Have you had a job  |   |   |              |                          |
| \ | that required you   |   |   |              |                          |
| . | to work from        |   |   |              |                          |
|   | heights and/or have |   |   |              |                          |
|   | you worked from     |   |   |              |                          |
|   | heights in a        |   |   |              |                          |
|   | non-job related     |   |   |              |                          |
|   | activity? If so,    |   |   |              |                          |
|   | describe in detail  |   |   |              |                          |
|   | the type of work or |   |   |              |                          |
|   | non-job related     |   |   |              |                          |
|   | activity,           |   |   |              |                          |
|   | [including the      |   |   |              |                          |
|   | approximate         |   |   |              |                          |
|   | h                   |   |   |              |                          |
|   | eights]{.underline} |   |   |              |                          |
|   | from which you have |   |   |              |                          |
|   | worked.             |   |   |              |                          |
+---+---------------------+---+---+--------------+--------------------------+

+---+----------------+---+---+------------------+----------------------------+
|   |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
|   |                |   |   |                  | ### Name                   |
+---+----------------+---+---+------------------+----------------------------+
| * |                |   |   |                  |                            |
| * |                |   |   |                  |                            |
| E |                |   |   |                  |                            |
| l |                |   |   |                  |                            |
| e |                |   |   |                  |                            |
| m |                |   |   |                  |                            |
| e |                |   |   |                  |                            |
| n |                |   |   |                  |                            |
| t |                |   |   |                  |                            |
| 4 |                |   |   |                  |                            |
| - |                |   |   |                  |                            |
| - |                |   |   |                  |                            |
| A |                |   |   |                  |                            |
| b |                |   |   |                  |                            |
| i |                |   |   |                  |                            |
| l |                |   |   |                  |                            |
| i |                |   |   |                  |                            |
| t |                |   |   |                  |                            |
| y |                |   |   |                  |                            |
| t |                |   |   |                  |                            |
| o |                |   |   |                  |                            |
| u |                |   |   |                  |                            |
| s |                |   |   |                  |                            |
| e |                |   |   |                  |                            |
| p |                |   |   |                  |                            |
| r |                |   |   |                  |                            |
| i |                |   |   |                  |                            |
| n |                |   |   |                  |                            |
| t |                |   |   |                  |                            |
| s |                |   |   |                  |                            |
| a |                |   |   |                  |                            |
| n |                |   |   |                  |                            |
| d |                |   |   |                  |                            |
| d |                |   |   |                  |                            |
| r |                |   |   |                  |                            |
| a |                |   |   |                  |                            |
| w |                |   |   |                  |                            |
| i |                |   |   |                  |                            |
| n |                |   |   |                  |                            |
| g |                |   |   |                  |                            |
| s |                |   |   |                  |                            |
| * |                |   |   |                  |                            |
| * |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| * |                | * | * | **Describe how   |                            |
| * |                | * | * | you have "used"  |                            |
| H |                | Y | N | the              |                            |
| a |                | e | o | d                |                            |
| v |                | s | * | rawings/diagrams |                            |
| e |                | * | * | and for what     |                            |
| y |                | * |   | purpose. If you  |                            |
| o |                |   |   | have completed   |                            |
| u |                |   |   | c                |                            |
| u |                |   |   | ourses/training, |                            |
| s |                |   |   | indicate the     |                            |
| e |                |   |   | title of the     |                            |
| d |                |   |   | course (no       |                            |
| t |                |   |   | course codes),   |                            |
| h |                |   |   | type of          |                            |
| e |                |   |   | school/training  |                            |
| f |                |   |   | (e.g., trade     |                            |
| o |                |   |   | school,          |                            |
| l |                |   |   | military,        |                            |
| l |                |   |   | correspondence,  |                            |
| o |                |   |   | etc.) course     |                            |
| w |                |   |   | length (number   |                            |
| i |                |   |   | of hours),       |                            |
| n |                |   |   | course           |                            |
| g |                |   |   | description, and |                            |
| d |                |   |   | if you           |                            |
| r |                |   |   | successfully     |                            |
| a |                |   |   | completed the    |                            |
| w |                |   |   | course.**        |                            |
| i |                |   |   |                  |                            |
| n |                |   |   |                  |                            |
| g |                |   |   |                  |                            |
| s |                |   |   |                  |                            |
| / |                |   |   |                  |                            |
| d |                |   |   |                  |                            |
| i |                |   |   |                  |                            |
| a |                |   |   |                  |                            |
| g |                |   |   |                  |                            |
| r |                |   |   |                  |                            |
| a |                |   |   |                  |                            |
| m |                |   |   |                  |                            |
| s |                |   |   |                  |                            |
| * |                |   |   |                  |                            |
| * |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 1 | Electrical     |   |   |                  |                            |
| \ | wiring         |   |   |                  |                            |
| . | diagrams       |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 2 | Schematic      |   |   |                  |                            |
| \ | diagrams       |   |   |                  |                            |
| . |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 3 | Electronic     |   |   |                  |                            |
| \ | drawings       |   |   |                  |                            |
| . |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 4 | One-line       |   |   |                  |                            |
| \ | diagrams       |   |   |                  |                            |
| . |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 5 | Mechanica      |   |   |                  |                            |
| \ | l/Construction |   |   |                  |                            |
| . | blueprints     |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 6 | Maps (road,    |   |   |                  |                            |
| \ | topographic,   |   |   |                  |                            |
| . | physical,etc.) |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
|   |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| * |                | * | * | **If you have    |                            |
| * |                | * | * | completed        |                            |
| H |                | Y | N | c                |                            |
| a |                | e | o | ourses/training, |                            |
| v |                | s | * | indicate the     |                            |
| e |                | * | * | title of the     |                            |
| y |                | * |   | course (no       |                            |
| o |                |   |   | course codes),   |                            |
| u |                |   |   | type of          |                            |
| t |                |   |   | school/training  |                            |
| a |                |   |   | (e.g., trade     |                            |
| k |                |   |   | school,          |                            |
| e |                |   |   | military,        |                            |
| n |                |   |   | correspondence,  |                            |
| c |                |   |   | etc.) course     |                            |
| o |                |   |   | length (number   |                            |
| u |                |   |   | of hours),       |                            |
| r |                |   |   | course           |                            |
| s |                |   |   | description, and |                            |
| e |                |   |   | if you           |                            |
| s |                |   |   | successfully     |                            |
| i |                |   |   | completed the    |                            |
| n |                |   |   | course.**        |                            |
| t |                |   |   |                  |                            |
| h |                |   |   |                  |                            |
| e |                |   |   |                  |                            |
| f |                |   |   |                  |                            |
| o |                |   |   |                  |                            |
| l |                |   |   |                  |                            |
| l |                |   |   |                  |                            |
| o |                |   |   |                  |                            |
| w |                |   |   |                  |                            |
| i |                |   |   |                  |                            |
| n |                |   |   |                  |                            |
| g |                |   |   |                  |                            |
| ? |                |   |   |                  |                            |
| * |                |   |   |                  |                            |
| * |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 7 | AC Theory      |   |   |                  |                            |
| \ |                |   |   |                  |                            |
| . |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+
| 8 | DC Theory      |   |   |                  |                            |
| \ |                |   |   |                  |                            |
| . |                |   |   |                  |                            |
+---+----------------+---+---+------------------+----------------------------+

<table>
<colgroup>
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 18%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 18%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 5%" />
<col style="width: 15%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 20%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="9"></td>
<td colspan="4">     </td>
</tr>
<tr class="even">
<td colspan="9"></td>
<td colspan="4"><h3 id="name-2">Name</h3></td>
</tr>
<tr class="odd">
<td colspan="13"><strong>Element 5 –</strong> <strong>Ability to Use
Tools (Part A)</strong></td>
</tr>
<tr class="even">
<td colspan="13"><strong>Instructions</strong>: Check the box next to
any of the following hand tools that you have used.</td>
</tr>
<tr class="odd">
<td></td>
<td>1.</td>
<td>Screw Drivers</td>
<td></td>
<td>10.</td>
<td>Hand Saws</td>
<td></td>
<td>19.</td>
<td colspan="2">Rakes</td>
<td></td>
<td>28.</td>
<td>Hand Drill</td>
</tr>
<tr class="even">
<td></td>
<td>2.</td>
<td>Hammers</td>
<td></td>
<td>11.</td>
<td>Pipe Wrench</td>
<td></td>
<td>20.</td>
<td colspan="2">Axe or Hatchet</td>
<td></td>
<td>29.</td>
<td>Hand Sander</td>
</tr>
<tr class="odd">
<td></td>
<td>3.</td>
<td>Pliers</td>
<td></td>
<td>12.</td>
<td>Vise/Clamps</td>
<td></td>
<td>21.</td>
<td colspan="2">Taps and Dies</td>
<td></td>
<td>30.</td>
<td>Files/Rasps</td>
</tr>
<tr class="even">
<td></td>
<td>4.</td>
<td>Open-end wrenches</td>
<td></td>
<td>13.</td>
<td>Paint Brushes</td>
<td></td>
<td>22.</td>
<td colspan="2">Side Cutters</td>
<td></td>
<td>31.</td>
<td>Tin Snips</td>
</tr>
<tr class="odd">
<td></td>
<td>5.</td>
<td>Socket wrenches</td>
<td></td>
<td>14.</td>
<td>Paint Rollers</td>
<td></td>
<td>23.</td>
<td colspan="2">Rulers</td>
<td></td>
<td>32.</td>
<td>Hot Glue Gun</td>
</tr>
<tr class="even">
<td></td>
<td>6.</td>
<td>Chisels/Punches</td>
<td></td>
<td>15.</td>
<td>Ladders</td>
<td></td>
<td>24.</td>
<td colspan="2">Levels</td>
<td></td>
<td>33.</td>
<td>Staple Gun</td>
</tr>
<tr class="odd">
<td></td>
<td>7.</td>
<td>Tape Measure</td>
<td></td>
<td>16.</td>
<td>Design Templates</td>
<td></td>
<td>25.</td>
<td colspan="2">Knife Sharpener</td>
<td></td>
<td>34.</td>
<td>Miter Box</td>
</tr>
<tr class="even">
<td></td>
<td>8.</td>
<td>Adjustable Wrenches</td>
<td></td>
<td>17.</td>
<td>Drawing Compass</td>
<td></td>
<td>26.</td>
<td colspan="2">Scribes/Awls</td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td>9.</td>
<td>Squares</td>
<td></td>
<td>18.</td>
<td>Shovels</td>
<td></td>
<td>27.</td>
<td colspan="2">Chalk Line</td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="13"><strong>Part A – Section 2: Describe two or three tasks
or projects where you have used some of the tools you’ve checked in Part
A above.</strong></td>
</tr>
<tr class="odd">
<td colspan="13">     </td>
</tr>
<tr class="even">
<td colspan="13"><strong>Element 5 – Ability to Use Tools (Part
B)</strong></td>
</tr>
<tr class="odd">
<td colspan="13"><strong>Instructions</strong>: Check the box next to
any of the following power tools or equipment that you have used.</td>
</tr>
<tr class="even">
<td></td>
<td>1.</td>
<td>Circular Saw</td>
<td></td>
<td>7.</td>
<td>Power Drill</td>
<td></td>
<td>13.</td>
<td colspan="2">Bench Grinder</td>
<td></td>
<td>19.</td>
<td>Lawn Mower</td>
</tr>
<tr class="odd">
<td></td>
<td>2.</td>
<td>Table Saw</td>
<td></td>
<td>8.</td>
<td>Drill Press</td>
<td></td>
<td>14.</td>
<td colspan="2">Arc Welders</td>
<td></td>
<td>20.</td>
<td>Weed Trimmer</td>
</tr>
<tr class="even">
<td></td>
<td>3.</td>
<td>Band Saw</td>
<td></td>
<td>9.</td>
<td>Hydraulic Presses</td>
<td></td>
<td>15.</td>
<td colspan="2">Oxyacetylene (gas) welders</td>
<td></td>
<td>21.</td>
<td>Tiller</td>
</tr>
<tr class="odd">
<td></td>
<td>4.</td>
<td>Chain Saw</td>
<td></td>
<td>10.</td>
<td>Wood/Metal Lathe</td>
<td></td>
<td>16.</td>
<td colspan="2">Soldering Iron</td>
<td></td>
<td>22.</td>
<td>Personal Computer</td>
</tr>
<tr class="even">
<td></td>
<td>5.</td>
<td>Jig Saw</td>
<td></td>
<td>11.</td>
<td>Dremel Tools</td>
<td></td>
<td>17.</td>
<td colspan="2">Sewing Machine</td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td>6.</td>
<td>Power Sander</td>
<td></td>
<td>12.</td>
<td>Router</td>
<td></td>
<td>18.</td>
<td colspan="2">Vacuum Cleaner</td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="13"><strong>Part B – Section 2: Describe two or three tasks
and/or projects where you have used some of the tools described in Part
B above.</strong></td>
</tr>
<tr class="odd">
<td colspan="13">     </td>
</tr>
</tbody>
</table>

+----+----+------------------------------+---+------------------------+
| #  |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   | ### Name {#name-3}     |
+----+----+------------------------------+---+------------------------+
| ## |    |                              |   |                        |
| ## |    |                              |   |                        |
| ## |    |                              |   |                        |
| #  |    |                              |   |                        |
| Co |    |                              |   |                        |
| nt |    |                              |   |                        |
| in |    |                              |   |                        |
| ua |    |                              |   |                        |
| ti |    |                              |   |                        |
| on |    |                              |   |                        |
|  S |    |                              |   |                        |
| he |    |                              |   |                        |
| et |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
| *  | ** |                              |   |                        |
| *E | Qu |                              |   |                        |
| le | es |                              |   |                        |
| me | ti |                              |   |                        |
| nt | on |                              |   |                        |
| ** | ** |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+
|    |    |                              |   |                        |
|    |    |                              |   |                        |
|    |    |                              |   |                        |
+----+----+------------------------------+---+------------------------+