Part I is the Apprenticeship Agreement, Part II is Worksite Training Completion or Termination and Part III is RI Completion.
Registration: the Apprentice is not registered until this form is signed by the authorized New York State Department of Labor representative.
Signatures: this form must be signed by the Apprentice, Apprentice's parent/guardian (if applicable), and Sponsor representatives.
Instruction: the Apprentice agrees to complete or fulfill a minimum of 144 hours of Related and Supplemental Instruction (RI) per year.
Probation: enter, in months, 25% of the length of the program, or one year, whatever is shorter.
Completion: the Department of Labor must receive the form within 30 calendar days of the completion/termination date.
| Question | Answer |
|---|---|
| Form Name | AT 401 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 61 |
| Avg. time to fill out | 11 min |
| Edition | Rev 06/24 |
| Where to send | Your regional DOL office |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | AT 401, AT401, Form AT 401, Apprenticeship Agreement, Apprentice Agreement |
| Official source | AT 401 (Rev 06/24), New York State Department of Labor |
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