Employer/Apprentice Agreement

Information Required

Business Name

Number of Employees

1 - 4 5 - 99 100 - 499

First Name

Last Name

Address Line 1

City

Province/ Region

Postal Code

Phone Number

Email Address

Name of Journey Person

First Name of Apprentice

Last Name of Apprentice

Date of Birth

Address

City

Province

Postal Code

Phone Number

Email Address

Trade:

Are you a Level 1 Apprentice?

HSAP Yes No

Please indicate (voluntary) any of the groups that you wish to be self-identified with:

If you already have a Copy of Apprenticeship Registration Letter OR Apprentice Pocket Card:

Sub-Agreement Consent:

I agree to the terms of this agreement:
(a) An acknowledgement from the Sub-Agreement Holder that they shall not enter into another Sub-Agreement with any other organization receiving funding under the Apprenticeship Service Program, within the same Fiscal Year, for the purpose of receiving a financial incentive; (b) a provision giving BNRC and ESDC the right to request an audit of the books and records as it relates to the financial incentive received: (c) a provision stipulating that payment of any funding under the agreement is subject to the availability of funds and that payment of funding may be cancelled or reduced in the event that ESDC cancels or reduces its funding to the BNRC. (d) a requirement for the Sub-Agreement Holder to cooperate with representatives of ESDC during any official news release or ceremonies relating to the announcement of the Sub-Agreement.I give my consent and acknowledge the BNRC to release information contained in this application to Employment and Social Development Canada (ESDC) and Apprenticeship Service Program (ASP) in accordance with the Privacy Act and for public advertising without any additional payment. Information collected will be used to determine my eligibility, evaluate the ASP and for accountability. Sub-Agreement Holder is required to repay BNRC the amount of any funding provided to which it is not entitled, made in error or were not eligible under the agreement. The amount of the incentive is based on the self-declaration (voluntary) and cannot be changed after the fact. A survey will be completed near the end of the project for feedback.

Signature of Apprentice

Signature of Employer

Employer/Apprentice Agreement

Information Required

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