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Anne Arundel County - Apprentice Information Form PW - 02
Apprentice Information Form PW - 02
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* Indicates required question
Apprentice Name
*
Your answer
Apprentice Job Classification/Program
*
Your answer
Apprentice Sponsor/Union Name
*
Your answer
Program Phase % and Period
*
Your answer
Hourly Rate $
*
Your answer
Fringe Rate $
Your answer
Fringe (Paid as Cash or to 3rd Party)
*
Option 1 Cash
Option 2 To 3rd Party
Option 3 Cash & 3rd Party
Other:
Provide Description of Fringes to 3rd Party with a $ Breakdown
*
Your answer
Have you attached the following?
*
Option 1 Signed Apprentice Agreement
Option 2 Copy of Maryland Apprentice License
Option 3 Apprentice Standards Breakdown (if not provided above)
Required
Name and Title of Person Completing Form
*
Your answer
Contact Information (address, phone #, & email)
*
Your answer
Option 1
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