APPRENTICE AGREEMENT - California

A B C D Official Use
D. O. Gender Ethnic Dependent
s
Education STATUS
APPRENTICE LAST NAME, FIRST NAME MIDDLE
A
PPRENTICE ADDRESS (NUMBER AND STREET / CITY, STATE & ZIP)
BIRTHDATE (mm/dd/yyyy)
Yes: No:
OCCUPATION
TERM OF APPRENTICESHIP STRAIGHT T IME
Hours Within Years Hours per day: 8 Hours per week:
This agreement is between the above named apprentice employed by the below named employer, and
DAY MONTH YEAR SIGNATURE OF APPRENTICE
NAME OF EMPL OYER
SIGNATURE - - SECRETARY / CHAIR / COORDINATOR DATE
A
DDRESS
SIGNATURE -- APPRENTICESHIP CONSUL TANT DATE
for the Administrator of Apprenticeship
DAS 1 (REV. 3/12) APPRENTICE AGREEMENT
E
FILE NUMBER Yrs Employ
F - VETERAN
State of California -- Department of Industrial Relations --DIVISION OF APPRENTICESHIP STANDARDS
APPRENTICE AGREEMENT
SOCIAL SECURITY NUMBER
PROGRAM SPO NSOR
AGREEMENT: The undersigned parties mutually agree that they will us e their best endeavors to secure employment and training for
the apprentice. The apprentice agrees to perform satisfacto rily all work and learning assignments. The provisions of the
Apprenticeship Standards for the above occupation adopted by the program sponsor and approved by the Chief of the Division of
Apprenticeship Standards, are hereby made a part of this agreement. An official copy of the standards is on file in the headquarters of
the Division of Apprenticeship Standards. This apprentice agreement will continue in effect until the training is completed or otherwise
terminated in accordance with the standards.
The apprentice commences participation under these standards on the date of execution of this agreement by the Apprentice. The
signatory apprentice is credited with having ______ months toward completion of the term of apprenticeship. The apprentice is
expected to complete training on or about ____________________, 20____ , upon satisfactory completion of the total remaining
hours of on-the-job training and hours and/or units of related and supplemental instruction.
COUNTY OF RESIDENCE
O*Net code
40
SIGNATURE OF EMPLOYER OR ITS REPRESENT ATIVE TITLE
A
CCEPTED BY DAS
for unilateral programs only ]
This agreement is approved by
I, the undersigned apprentice understand and agree that this agreement is approved conditioned on obtaining an apprentice license
from the State Board of Barbering and Cosmetology, and if I fail to obtain this license within 90 days from the date of signing this
agreement this agreement will be cancelled.
I, the undersigned apprentice, hereby request that the Administrator of Apprenticeship terminate any other apprenticeship agreements
in which I am currently registered.
Executed this _______ day of _________________ , 20____ by _______________________________________________
AGREED TO BY THE EMPLOYER
SIGNATURE OF PARENT OR GU ARDIAN (IF APPRENTICE I S 16 OR 1 7)
AGREED TO AND APPROVED BY, FOR THE COM MITTEE
APPRENTICE: I, the undersigned apprentice, understand and agree that t here is a valid and reasonable necessity that those
academic records accumulated throughout related and supplemental instruction during my period of apprenticeship be made available
to the apprenticeship committee. Further, I agree to release to the apprenticeship committee any other academic records which I feel
may enhance my status as an apprentice.
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