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Registration
Step
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2
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Employer Information
Company Name
(Required)
Company Mail Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Primary Contact Name
(Required)
Primary Email
(Required)
(This will be used for ALL FWAPHCC communications related to the apprenticeship program)
Primary Phone
(Required)
Alternate Phone
Additional Contacts
Alternate Contact Name
Alternate Contact Email
Alternate Contact Phone
Billing Contact Name
Billing Contact Email
Billing Contact Phone
Employer Responsibilities
Consent
(Required)
By signing this document, as an employer of apprentice(s) enrolled in the FWAPHCC Apprenticeship Program, you agree to the following:
• All apprentices within my company have been registered with the Office of Apprenticeship
• My company will maintain an active membership with IAPHCC for the entire school year if I receive the member discount toward tuition. Failure to maintain current and active membership will place apprentices in jeopardy of being unenrolled.
• I am accountable for all fees associated with the apprentice(s) tuition as listed on the fee schedule on page 11 of the registration packet.
• I understand that the $100 registration fee will be applied to the apprentice’s 1st term tuition. If the apprentice does not attend the upcoming school year, this fee will not be refunded.
• During the apprenticeship program, I will ensure my plumbing apprentice(s) are obtaining the required 1600 hours of OJT per year.
• I understand each apprentice is allowed to miss only one class per term. More than one absence in a term may result in the apprentice being removed from the program.
• I confirm that the apprentice(s) is a W2 employee who receives a W2 tax form from the company referenced above.
• I have read and fully understand FWAPHCC Payment Policy located on page 11.
• To arrange the apprentice(s) work schedule to permit attendance in class.
• To notify the Executive Coordinator if an apprentice ceases to be employed by my company.
• I understand that I must provide a copy of the Apprenticeship Agreement for each of my plumbing apprentices (if not already on file) with this registration form. How to obtain the agreement can be found on page 7.
• I understand that obtaining an apprentice license for my plumbing apprentice(s) is mandatory and that the PLA’s application fee is separate from FWAPHCC forms and fees. How to register your apprentice with the PLA’s office is found on page 8.
Date
(Required)
MM slash DD slash YYYY
Signature
(Required)
Apprenticeship Enrollment
Apprenticeship Enrollment
Row ID
Apprentice Name
Year
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