APPRENTICE REGISTRATION – SECTION II
This agreement does not constitute a certification under Title 29 Code of Federal Regulations (CFR) Part 5 for the employment of the apprentice on Federally financed or assisted construction projects. Current certifications must be obtained from the Office of Apprenticeship (OA) or the recognized State Apprenticeship Agency.The program sponsor and apprentice agree to the terms of the Apprenticeship Standards incorporated as part of this agreement and in accordance with Title 29 CFR Parts 29 and 30. The sponsor’s Apprenticeship Standards are attached and hereby incorporated into this agreement as they exist on the date of the agreement. These Standards may be amended during the period of this agreement with the consent of the parties to the agreement. This agreement may be terminated by either of the parties, citing cause(s), with notification to the registration agency, in compliance with Title 29 CFR Part 29
Apprenticeship Application Form
PART A: TO BE COMPLETED BY APPRENTICE. NOTE TO SPONSOR: PART A SHOULD ONLY BE FILLED OUT BY APPRENTICE.
Name
*
Prefix
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Social Security Number
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender
*
Male
Female
Ethnicity
*
Please Select
Hispanic or Latino
Not Hispanic or Latino
Participant Did Not Self-Identify
Race (Mark one or more)
*
Please Select
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other PacificIslander
White
Participant Did Not Self-Identify
Veteran Status
*
Please Select
Non Veteran
Veteran
Non Veteran, Other Eligible Individual
Veteran, Eligible
Participant Did Not Self-Identify
Disability
*
Yes
No
No Answer
Employment Status:
*
New Employee
Existing Employee
Career Connection
*
Pre-Apprenticeship
Military Veterans
Technical Training School
School to Registered Apprenticeship
Sponsor Program
*
Please Select
KIDS Humpty Dumpty Academy 106 E Abrams St Arlington
KIDS Rainbow Academy (Ft Worth)
KIDS Montessori Academy (Richardson )
Credit for Previous Experience (Hrs, Mos, Years)
*
Term Remaining (Hrs, Mos, Years)
*
Education:
*
Please Select
High School Graduate or GED
Some College or Associates
Degree Bachelors
Master Degree
Doctorate Degree
Date Apprenticeship Begins (2 Year Program)
*
-
Month
-
Day
Year
Date
Date Apprenticeship Ends (2 Year Program)
-
Month
-
Day
Year
Date
Are you ready to be interviewed?
*
Yes
No
Prior Hourly Wage$
*
Apprenticeship Entry Hours Wage $
Have you ever been convicted of a criminal offense or currently have charges outstanding?
*
Yes
No
Please give details
I agree the following statements
*
I confirm that all the information I provided here are true and accurate.
I understand that any false or omitted information provided here may result in termination of right of apprenticeship.
Date
*
-
Month
-
Day
Year
Date
Signature
*
Submit
Should be Empty: