DVA NCCER CORE- Student Application

Training Provider	OICA ACANA
Cohort Capacity	20 students
Anticipated Start	November 2, 2026
Program Length	10 instructional weeks / approximately 200 hours
Training Schedule	20 hours per week - final daily schedule to be provided

Applicant Instructions: Complete all required sections. Please print clearly. Information marked optional is used for reporting or support planning and is not used to discriminate in admissions. Submitting an application does not guarantee admission, credential attainment, apprenticeship, or employment.
Section 1 - Applicant Information
Full Legal Name

First NameLast Name
Preferred Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone
Format: (000) 000-0000.
Email Address
example@example.com
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred Contact
Emergency Contact Name

First NameLast Name
Emergency Contact Phone / Relationship
Optional Demographic Information
Complete only if requested for program/funder reporting. Declining to answer will not by itself affect admission.
Race/Ethnicity (optional)
Gender (optional)

4. Are you prepared to pursue employment, apprenticeship, or additional craft training after completion? Please explain.
Section 5 - Availability & Commitment
Please check each statement that accurately reflects your current commitment:
Known scheduling conflict(s), if any

Section 6 - Training Safety & Reasonable Accommodation
NCCER Core may include classroom work and supervised hands-on construction activities involving tools, materials, lifting/handling exercises, PPE, standing, movement around a training area, and safety procedures. Applicants are not required to disclose a diagnosis or broad medical history on this application.
Section 7 - Applicant Certification & Authorizations
I understand that I am applying for NCCER Core construction training and that the program includes classroom instruction, assessments, and hands-on activities.
- The anticipated cohort begins November 2, 2026.
- The program is approximately 10 instructional weeks and 200 scheduled training hours.
- The expected schedule is 20 hours per week.
- Attendance, punctuality, safe conduct, participation, and completion of required training activities are essential.
- NCCER credential requirements and local program completion requirements may be separate.
I certify that the information I provided is accurate to the best of my knowledge. I understand that material falsification may affect enrollment. I authorize the training provider to contact me regarding this application and program participation. I understand that any separate release for media, employer referral, or information sharing will be presented separately where required.
Applicant Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Rows	Employed FT Other	Employed PT	Unemployed	Student
Current / Most Recent Employer
Job Title / Duties
Previous Construction Experience
Tools / Equipment Previously Used