Apprentice Agreement - Massachusetts
APPRENTICE AGREEMENT
Pursuant to the Standards of Apprenticeship adopted by the Sponsor and registered with the Massachusetts Division of Apprentice Standards,
the provisions of which are hereby made part of this Agreement, and in compliance with the Massachusetts Plan for Equal Employment in
Apprenticeship Standards, WITNE
SSETH: that the Agreement is entered into by the undersigned:
/ ________________________________________________________
(Name of Apprentice) (Address of Apprentice)
(Name of Program Sponsor) (Employer, JAC, JATC, Assoc. of Employers or Org. of Employers.)
OCCUPATION: ______________ TERM OF APPRENTICESHIP________________ HOURS.
DATE APPRENTICESHIP BEGINS: ____ _____ PROJECTED COMPLETION DATE: ______________________
CREDIT FOR PREVIOUS: OJT EXPERIENCE:_____________ RELATED TRAINING HOURS STARTING STEP #___ _____
GRADUATED SCALE OF WAGES IN (PERCENTAGES TO BE PAID THE APPRENTICE. PERCENTAGES ARE BASED ON JOURNEY PERSON
WAGES)
On projects where there is a prevailing rate set by law, the rate of pay shall comply with the wage rate or percentages stated on the wage
schedules issued by the Department of Labor Standards. The percentages below are to be used on all other jobs
PERIOD(s):__________________________
1
st
3
rd
5
th
7
th
9
th
2
nd
4
th
6
th
8
th
10
th
M inimum Journey person rate as of (Date) is $ per ho ur
____________ Hours/day ____________Hours/week Overtime Rate: _________________
The pa rties hereto ag ree t hat the terms stated on the reverse side of t his form are par t o f t his agreement. I hereby authorize
the Divisio n of Apprentice 6WDQGDUGV to request access to all my related training records directly from any school/training
progr
am I m
ay attend as part of my apprenticeship.
____________________________________________________________
(Signature of Apprentice) / (PLEASE SIGN IN BLUE INK)
_________________________________________________________________
(Signature of Program Sponsor) / (PLEASE SIGN IN BLUE INK)
(Signature Parent/Guardian, If Minor)
__________________________________________________________________
(Address of Program Sponsor)
__________________________________________________
(Signature of Union JAC, JATC) / (PLEASE SIGN IN BLUE INK)
Approved by the Division of Apprentice 6WDQGDUGV: _____________________________ Date: ________
Version: 10/15/2013
FOR OFFICE USE ONLY
The Commonwealth of Massachusetts
Department of Labor Standards
Division of Apprentice Standards
19 Staniford Street, 2
nd
Floor, Boston, MA 02114
Compliance Officer Number:
__________
Sponsor Number____________________
APPRENTICE STATUS
DATE
Date Entered
Completed / Certificate
Suspended
Cancelled
Military Service
Deceased
Annual Fee: $35.00 for photo ID (please include one passport size photo)
Apprentice ID Number
:
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