Online Referral Follow Up Form Online Referral Follow Up Form Participating Employer Participating Employer3T Plumbing IncA Pederson's PlumbingA-1 PlumbingAdvantage Plumbing IncAlbin's PlumbingAlpine Plumbing and Mechanical LLCB.C. Plumbing, Inc.B&G Excavation & Plumbing LLCBathtub Solutions IncBeaver Plumbing & Heating IncBerry Plumbing, IncBethell Plumbing LLCBlakely PlumbingBlazer Industries IncBrass PlumbingBuckmaster Pro Plumbing & HeatingBudget Rooter of OregonCaliber Plumbing & Mechanical IncCamps Plumbing LLCCherry City Plumbing IncComplete PlumbingCorbett Mechanical IncDoneRite Plumbing LLCDSL BuildersEvenflo PlumbingEvergreen Plumbing & Mechanical LLCFair Share Construction LLCFriesen Plumbing IncG3 PlumbingGagles HeatingGarcia Plumbing LLCGemini CorpGLS PlumbingGo Plumbing & Heating LLCHammerquist IncHR Mechanical Services LLCHydro Temp Mechanical IncII-S Mechanical IncInnovative Plumbing and MechanicalISO Plumbing & MechanicalJack Wallace PlumbingJC Plumbing LLCJet Industries IncJims PlumbingJohn's WaterproofingJoling EnterprisesJudsons, IncLamberts Plumbing SolutionsLebanon Servco IncLeftco IncLifeworks PlumbingLincoln Plumbing IncLinn-Benton Plumbing LLCLovett, Inc.Lundell PlumbingMajors Plumbing IncMckillips Plumbing LLCMGR PlumbingMidway Plumbing IncModern Building SystemsMr. RooterNeu Flo PlumbingNewport PlumbingNofco Plumbing LLCNoordam Plumbing IncOn Track PlumbingOregon Cascade Plumbing & HeatingOregon Coast Pipe FittersOut West Plumbing IncPebbles Plumbing and MechanicalPipewerksPittman Plumbing & HeatingPKG ConstructionPlumbing 101 LLCPlumbers Northwest IncProline PlumbingPure PlumbingQuality West Plumbing LLC (Cascade Plumbing)R & R General Contractors IncRau Plumbing IncRG Smith Electrical Contracting IncRidgeline PlumbingRod Stutzman PlumbingRod's Plumbing, LLCRon Knight PlumbingRoth Heating & CoolingRoto-Rooter Service CompanySlayden Constructors IncSpaniols IncStutzman Services IncSuperior Plumbing of Oregon IncTerry Massey PlumbingThe Plumbers IncThomas Forbes Plumbing CoThrasher Plumbing LLCTIC Building LLCTip Top Plumbing, Inc.Town & Country Plumbing IncorporatedTwo Dogs Plumbing & DrainVicon Mechanical Contractor & PlumbingWolfers, Inc.None Company Representative First Name Company Representative Last Name Company Representative E-Mail Is this an Applicant or an Apprentice? Is this an Applicant or an Apprentice? Applicant Apprentice Apprentice/Applicant First Name Apprentice/Applicant Last Name Record of Activity Record of Activity I have interviewed this individual I have declined to interview this individual for the following reasons: I have declined to interview this individual for the following reasons: Record of Determination - (Applicants are not to be Interviewed) Record of Determination - (Applicants are not to be Interviewed) I intend to hire the above named individual I do not intend to hire the above named apprentice/applicant for the following reason(s): Select all that apply Select all that apply Insufficient work experience (Out-of-Work Apprentices Only) Found Other Employment Did not want to work for our company Other, Please Explain: Please Explain: Acceptance of Conditions Acceptance of Conditions I understand that the Exit Survey and Release Form is to be submitted within 3 days of termination of employment. Companies remain financially responsible for all monthly billings up to and including the months between termination of employments and receipt of an exit survey by Area II Plumbers JATC. Comment Section 10 + 2 = Submit