Learning a skill or trade is an invaluable way to open up new opportunities for yourself and build valuable skills for future endeavors. In Virginia, you can get a head start on your career goals by becoming an apprentice in almost any field such as engineering, manufacturing, construction, automotive repair and more. If you are interested in apprenticeship opportunities in Virginia, the first step is to fill out a Virginia Apprentice Action Form which allows prospective apprentices to register with the labor department so they become eligible for job placements. Through this form applicants provide contact information and relevant background details that can help them gain access to high-quality programs throughout the state. Read on to learn more about what types of information goes into the Virginia Apprentice Action Form as well as how prospective apprentices can complete it successfully!
Question | Answer |
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Form Name | Virginia Apprentice Action Form |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | CFR, SSN, DONATI, aprehetice form |
COMMONWEALTH OF VIRGINIA APPRENTICESHIP PROGRAM DEPARTMENT OF LABOR AND INDUSTRY
13 S. 13TH STREET RICHMOND, VIRGINIA 23219
APPRENTICE ACTION FORM
FIELD REP LAST NAME/#
SPONSOR NO
In accordance with the Privacy Protection Act of 1973, Sections
The program sponsor and apprentice agree to the terms of the Apprenticeship Standards incorporated as part of this Agreement. The sponsor will not discriminate in the selection and training of the apprentice in accordance with the Equal Opportunity Standards in Title 29 CFR Part 30.3 and Executive Order 11246. 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 29.6
Apprentice Name: (Type or print name as it should appear on completion certificate) |
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First Name |
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Middle Initial |
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Last Name |
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Address |
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City |
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Zip Code |
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SSN |
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Sex |
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Occupation |
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Date of Birth |
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Veteran |
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DOT/O*NET Code |
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Race |
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Credit |
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Length of Program |
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Hours - Probation |
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Hours |
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Starting Date |
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Education Level |
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Estimated Completion Date |
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Name & Location Where Attained (If Credit Given) |
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Previously Registered as an apprentice with the State of Virginia only? |
Yes |
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No |
Name of company/sponsor? |
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Related Instruction will be covered through |
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Related Instruction |
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Apprentice Wages For Related Instruction |
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(Number Hours Per Year) |
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Will Be Paid |
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Will Not Be Paid |
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Competency |
X |
Time Based |
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Hybrid |
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Signature of Apprentice |
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Date |
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Signature of Parent/Guardian (if minor) |
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Date |
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Sponsor |
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Name of Sponsor Representative |
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Address |
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City/County |
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FIPS |
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State |
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Phone |
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Fax |
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PLEASE CHECK IF THIS IS A |
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REGISTRATION |
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SUPERSEDING AGREEMENT |
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REINSTATEMENT |
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STUDENT (H.S. CODE) |
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COMMUNITY COLLEGE CODE |
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Journeyworker's Hourly Wage $ |
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Apprentice's Entry Hourly Wage $ |
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WAGES |
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Term |
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Period 1 |
2 |
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3 |
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(Hrs) |
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Wage Rate |
$ |
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(Mark One) % |
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Signature of Sponsor's Representative |
Date Signed |
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Name and Address of Sponsor Designee to Receive Complaints (if applicable) |
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Registered with the Virginia Department of Labor and Industry |
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Commissioner |
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Date |
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COMPLETION Additional Credit Hours at time of Completion |
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(2,000 hours or more a letter is required) |
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Signature of Sponsor's Representative |
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Title |
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Date |
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Signature of Related Instruction Coordinator |
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Date |
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CANCELLATION |
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EFFECTIVE DATE |
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Reason |
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Signature of Sponsor's Representative |
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Date |
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Revised 2011 |
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