HTML Preview Apprenticeship Agreement Form page number 1.
a. b.
c.
5. APPRENTICE'S ADDRESS (Street, City, County, State, Zip Code)
a. b. c.
d. e. f.
a. b. $
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DATE SIGNED
11. TRADE
(Employer/Sponsor) DATE SIGNED
23. SIGNATURE OF AUTHORIZED OFFICIAL
20. VETERAN STATUS ("X" One)
21. APPRENTICE WAGES- The apprentice schedule of pay shall be listed after each advancement period. The work processes listed in the
19. PRESENT JOURNEYPERSON'S HOURLY WAGE RATE
14 CREDIT FOR PREVIOUS
EXPERIENCE (Hours)
18. APPRENTICE WAGES FOR RELATED INSTRUCTION TRAINING ("X" One)
22. SIGNATURE OF COMMITTEE ( if applicable)
DATE SIGNED
A. B. C. A. B. C. A. B. C.
17. RELATED INSTRUCTION TRAINING
(Hours) (Hours) (Hours)
15. TERM REMAINING (Hours) 16. DATE APPRENTICESHIP BEGINS
8. RACE/ETHNIC GROUP ( "X" one)
13. PROBATIONARY PERIOD (Hours)12. TERM OF APPRENTICESHIP (Hours)
2. DATE OF AGREEMENT
7.SEX ("X" one)
PLEASE TYPE OR PRINT CLEARLY) 5/08
D.O.T. NUMBERPROGRAM REGISTRATION NUMBER SOCIAL SECURITY NUMBER
APPRENTICESHIP AGREEMENT
APP-50
(Month, Day, Year)
DATE
3. NAME OF APPRENTICESHIP STANDARDS (NAME & ADDRESS)
6.DATE OF BIRTH (MM/DD/YY)
There shall be a period of probation of not more than four (4) months during which the apprenticeship agreement may be terminated by
either party to the agreement upon written notice to the registration agency. After the probationary period, the agreement may be
suspended, cancelled, or terminated by the supervisor by mutual agreement of the parties, or by the supervisor for good and sufficient
reason, with due notice to the apprentice and reasonable opportunity for corrective action, and with written notice to the apprentice and to
the sponsor of final action taken. All controversies or differences concerning the apprenticeship or on-the-job training agreement which
cannot be adjusted by the parties shall be submitted to the supervisor for determination as provided in KRS 343.070.
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9.SIGNATURE OF APPRENTICE DATE 10.SIGNATURE OF PARENT/GUARDIAN (If minor)
4. NAME OF APPRENTICE (Last, First, Middle)
The program sponsor and apprentice agree to the terms of apprenticeship standards as incorporated as part of this agreement.
1. AGREEMENT BETWEEN
APPRENTICE AND: ("x" one)
26. SIGNATURE (Supervisor of Apprenticeship)
DATE REGISTERED
SIGNATURE OF COMMITTEE ( if applicable)
24. REGISTRATION AGENCY FOR STATE AND FEDERAL PURPOSES
KENTUCKY LABOR CABINET
DEPARTMENT OF WORKPLACE STANDARDS
DIVISION OF EMPLOYMENT STANDARDS, APPRENTICESHIP AND
TRAINING IN COOPERATION WITH THE APPRENTICESHIP & TRAINING
COUNCIL
25. NAME AND ADDRESS OF DESIGNEE TO RECEIVE INQUIRIES
standards (item 3 above) are part of this agreement.
PERIOD TERM % PERIOD TERM % PERIOD TERM %
(MM/DD/YY) (No. Hrs/Yr.)
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