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Membership Skill Data Sheet ( Flooring )Skills Experience: Training Completed:□ Athletic Track (916) □ Armstrong Level 1 (930)□ Blueprint Reading - Com/Ind(202) □ Armstrong Level 2 (931) ↓Rollover (may select multiple)□ Blueprint Reading - Mechanical(945) □ Armstrong Level 3 (932) ↓□ Carpet Tile(908)□ COVID 19 - Class(803) Indiana□ COVID 19 - Vaccination(804)□ Disaster Site 1.5(928) □ □ Evansville□ Concrete Preparation(903)□ Disaster Site 7.5(927) □ □ Fort Wayne□ Cove Base(922) □ OSHA 10 Construction (111) □ □ Merrillville□ Double Stick Carpet(909) □ OSHA 30 Construction (132) □ □ Indianapolis□ Engineered Wood Floor(913) □ OSHA 10 General Industry (946) □ □ Kokomo□ Flash Cove(925) □ OSHA 30 General Industry (947) □ □ Lafayette□ Floors - VCT(251) □ OSHA 500 (135) □ □ Muncie□ Floors - Marble & Tile(259) □ OSHA 510 (136) □ □ South Bend□ Floors - Vinyl(249) □ CPR & First Aid /AED (118) □ □ Terre Haute□ Fritz Tile(915) □ Fall Protection (124)□ Glue Down Carpet(911) □ Forklift PITO Industrial (125) Kentucky□ Hand Sewing Carpet(906) □ Forklift PITO Rough Terrain (127) □ □ Ashland/Grayson□ Heat Welding(924) □ ICRA 24 (164) □ □ Lexington□ Layout I.D.(921) □ INSTALL Carpet Certification (170) □ □ Louisville□ Linoleum(914) □ INSTALL Substrate Cert (933) □ □ Paducah□ LVP/LVT(900) □ MONDO (943)□ Matting(902) □ MEWPS - CITF (165)□ Millwork Base(923) □ Nora Academy (934) Ohio□ Polished Concrete(918) □ NWFA Installation Cert (939) □ □ Canton□ Poured Floors/Epoxy(917)□ NWFA Sand & Finish(940) □ □ Cincinnati/Dayton□ Rubber Floor(901)□ Protectol(942) □ □ Cleveland□ Solid Wood Floor/Nail/Glue(912)□ Silica Awareness(929) □ □ Columbus□ Stair Treads(919)□ Tarkett Elite Linoleum(938) □ □ Lima□ Stretch Carpet(910)□ Tarkett EliteVinyl(936) □ □ Marietta□ Tufted Grass / Field Turf(905)□ Tarkett Select Linoleum(937) □ □ Norwalk□ Wall Carpet(907)□ Tarkett Select Vinyl (935) □ □ Portsmouth□ Wood Subfloor Preparation(904) Supervision Experience: □ □ Steubenville/Youngstown□ Foreman (522) □ □ Toledo□ General Foreman (521)□ Superintendent (510)Signature:_______________________________________ Date:____________________________________________County: _____________________________ State: ___________ Zip: ________________ Phone# ( ) __________________________Check all work areas and training you are qualified to perform. The data you provide is on the honor system.If you are discharged for inability to perform an indicated skill, then that skill will be deleted from your Skill Data Sheet.CENTRAL MIDWEST REGIONAL COUNCIL OF CARPENTERSRev 05/2024Primary (select only one)Geographical Work Areas:This Skill Data Sheet must be returned to your Local Union office. With this information, we can better serve the membership NOTE: The Geographical Work Area "Rollover List" will be used after the area "Primary List" is exhausted. If there are skills which you would like to learn or improve, The Regional Council Apprenticeship and Journeyperson Training Program offers skill enhancement classes for all members. For details, please contact the local training center in your area.and our signatory contractors. All information is maintained confidentially in our computer system.Name: ______________________________________________________ UBC#: _____________________DOB:________________________________Address: ____________________________________________________________________ City: ____________________________________