Government of Newfoundland and Labrador Department of Advanced Education and Skills Division of Apprenticeship and Trades Certification

Office Use Only:

Apprenticeship Registration Number:

Program Development Officer (PDO) Stamp

Apprenticeship Application Applicant Information

*Indicates required fields and must be completed or application will be returned

*Trade:

*First Name: *Middle Name: *Last Name:

*Social Insurance Number *Date of Birth (D/M/Y) / / Day Month Year

*Gender Male Female

*P.O. Box Number/Street Address: *City/Town:

*Province: *Postal Code: *Country:

*Email *Phone Number(s) Home: Cell:

Name of Post-Secondary Training Program Completed

Year Completed

Are you certified in another trade? Yes No

If Yes: Name of Trade:

Provincial/Interprovincial Number:

THE DEPARTMENT OF ADVANCED EDUCATION AND SKILLS WILL USE AND DISCLOSE PERSONAL INFORMATION ONLY IN ACCORDANCE WITH THE ACCESS TO INFORMATION AND PROTECTION OF PRIVACY OFFICE ACT (ATIPPA). TO CORRECT OR ACCESS YOUR PERSONAL

INFORMATION, PLEASE CONTACT THE APPRENTICESHIP AND TRADES CERTIFICATION DIVISION OFFICE IN YOUR AREA.

*Applicant Declaration I understand that my personal information and transcripts specific to my completed Post-Secondary Trades Training Program completed at the following training institution will be shared with the Apprenticeship and Trades Certification Division. Training Institution and Location/Campus:

I Agree I Do Not Agree Signature (if not submitting online)

Date:

Apprenticeship Application Page 2

Examination Accommodations Where available, the Apprenticeship and Trades Certification Division will provide reasonable accommodations to candidates having physical, emotional or learning barriers. To be eligible for examination accommodations, candidates must provide supportive medical or other professional documentation to the Division. The documentation must:

• Be prepared and signed by a qualified professional; and • Clearly identify a diagnosis or need and provide information that assists in determining what

accommodations may be required.

Will you require assistance or accommodations? Yes No

If Yes, have you included the specified documentation? Yes No

Previous Trade-Related Employment To have previous work experience reviewed by a Program Development Officer for possible credit towards your apprenticeship program, complete a Record of Work Experiences for Trade Qualifier or Pre-Apprenticeship Credits form for each employer, and submit with this application. The required form is at http://www.aes.gov.nl.ca/app/forms/recordofwork.html.

Current Employer Information

*Company Name: *Company Representative:

*Journeyperson Supervisor: *Journeyperson Certificate Number:

*P.O. Box/Street: *City/Town:

*Province: *Postal Code: *Country:

*Email:

*Telephone Number: Fax Number:

Submitting Your Application Faxed copies will not be accepted

By Email: Complete and save this form to your device. Open your email, and attach the saved form. Email the form to ApprenticeshipOnline@gov.nl.ca. The Apprenticeship and Trades Certification Division will

obtain your official transcript directly from your Post- Secondary Training Institution and the Memorandum of Understanding (MOU) from your new employer. **PLEASE NOTE: If relevant post-secondary education has NOT been completed, a high school transcript or equivalent must be attached to this application.

In Person or By Mail: Complete and print this form Attach the original official transcript from your Post-

Secondary Training Institution OR **high school transcript or equivalent.

Attach the completed MOU. (http://www.aes.gov.nl.ca/app/forms/mou.pdf) and bring all documents to an Apprenticeship and Trades Certification Division Office nearest you OR mail to:

Department of Advanced Education and Skills Apprenticeship and Trades Certification Division

Industrial Training Section 42 Hardy Road

Grand Falls-Windsor, NL A2A 1W9