ETA-671 Program Registration and Apprentice Agreement, Section I

Program Registration and U.S. Department of Labor

Apprenticeship Agreement Employment and Training Administration

Office of Apprenticeship

Program Registration – Section I

OMB No. 1205-0223, Expires: 01/31/2012

PROGRAM SPONSOR INFORMATION

1. Employer Identification Number

2. Program Number

3. Name of Organization

4. Address

5. City

6. State

7. Zip Code

8. Program Sponsor Is a “Green Jobs” Supporting Employer (See Definition) (Check Box)

8.a Yes 8.b No

9. Program Sponsor is participating in activities related to the “Recovery Act” of 2009 (See Definition) (Check Box)

9.a Yes 9.b No

PROGRAM SPONSOR’S RELATED CONTACT INFORMATION

10. Name of Sponsor Contact/Coordinator

11. Telephone Number

12. Extension

13. Fax Number

14. E-Mail Address

JOURNEYWORKERS EMPLOYED

15. Sponsor’s Occupational Title if Different from O’Net’s Titles

16. Female

17. Minority

18. Youth

19. Total

RELATED TECHNICAL INSTRUCTION INFORMATION (RTI)

20. Instruction Method

21. Delivery Technique

22. Instruction Provider

23. Wages Paid During RTI

Check Box 23.a Yes 23.b No

24. Hours of RTI Instruction Provided Per Year Only

25. RTI hours and On-the-Job Learning during Length of Program

26. RTI Provided By

RTI SOURCE INFORMATION

27. Select an RTI Option (Only Complete if More Than One RTI Provider)

28. Create a New RTI Source

29. Name of Source

30. Contact Person

31. Address of Source

32. Zip Code

33. City

34. State

PROGRAM SPONSOR
35.a Signature	35.b Title	35.c Program Registration Date( MO/DD/YYYY)

TO BE COMPLETED BY APPRENTICESHIP AND TRAINING REPRESENTATIVE (ATR) ONLY
36. ATR Name
37. ATR’s RAPIDS Identification Number

PROGRAM REGISTRATION INFORMATION

38. Bargaining Agency

38.a. Name

38.b National Affiliation

39. Program Type (Check Box)

39.a 1 = INJ

39.b 2 = IJ

39.c 3 = GJ

39.d 4 = GNJ

40. Number of Participating Employers

41. Employers: If GNJ Program, Attach Employer Acceptance Agreements. (Check Box) 41.a Yes, Agreement is attached. 41.b No, Agreement is not attached.

42. Waiver (Check Box) 42.a Yes 42.b No

43. Size of Workforce (includes all employees)

44. Bargaining Agency Contact

45.a Name

45.b Title

46. Street Address

47. City

48. State

49. Zip Code

50. Telephone Number

51. Cell Telephone Number

52. Fax Number

53. E-mail Address

54. Web-Site Address

55. North American Industrial Classification System (NAICS)

55.a Employer NAICS Code

55.b NAICS 2 Digit Category

55.c Products/Services

56. Apprenticeship Committee Exists (Check Box) 56.a Yes 56.b No

57. Membership List Is Attached (Check Box) 57.a Yes 57.b No

58. Occupational Title

59. Rapids Code

60. Apprenticeship Term in Hours (See Instructions)

61. Probation Length in Hours (See Instructions)

60.a Number of Hours

61.a Number of Hours

62. Written School-To-Apprenticeship Agreement (STA) (Check Box)

62a Yes 62.b No

63. Prison Indicator (Check Box)

63.a Yes 63.b No

64. Affirmative Action Plan (Check Box)

64.a Yes 64.b No

65. Selection Procedures (Check Box)

65.a Yes 65.b No

66. WAGE RECORD (Includes Four Wage Schedules)

66.a Wage Schedule

66.b Increment Type

66.c Start Date MO/DD/YYYY

66.d Apprentice Entry Wage Rate (Hour, Month, Year)

66.e Journeyworker Wage Rate

66.f Number of Periods

(1.

(2.

(3.

(4.

67. Program Registration Date (MO/DD/YYYY)	68. Last Program Revision Date (MO/DD/YYYY)

69. ATR
69.a Signature	69.b State (2 Digit Alpha)	69.c Date (MO/DD/YYYY)

Program Definitions and/or Instructions:

Unless otherwise indicated below, the program sponsor responds to Fields 1., 3. – 33.a-c and the ATR responds to fields 34 – 66.a-c.

1. Employer Identification Number (EIN) - is an Internal Service Revenue Federal tax identification number that is used to identify a business entity. The submission of your EIN is voluntary. The employer who enters this number is verifying that the business is legitimate with intentions of maintaining a registered program and training apprentices. This quality assurance check protects the welfare of the apprentice.

2. Program Number - a program generated number assigned to a sponsor program when the program is registered in the Registered Apprenticeship Partners Information Data System (RAPIDS), the Office of Apprenticeship database.

3.-7. Self-explanatory.

8. Program Sponsor Is a “Green Jobs” Supporting Employer – Program sponsor has incorporated skills training for green jobs into the registered apprenticeship program.

9. Program Sponsor is participating in activities funded by the “Recovery Act” of 2009 – The Act (sometimes referred to as the “Economic Stimulus”) is intended to preserve and create jobs, promote the nation’s economic recovery, and assist those most impacted by the recession. As a direct result of jobs maintained or created by the Act’s-funded activities, the program sponsor employed this apprentice.

10.-14. Self-explanatory.

15. Sponsor‘s Occupational Title – Specific title of an occupation that may or may not be the same as that designated by the O’Net data system.

16. Female - the number of female journeyworkers in this occupation.

17. Minority - the number of minority journeyworkers in this occupation.

18. Youth - the number of workers between the ages of 16 and 21 in this occupation (best guess).

19. Total - the number of total journeyworkers in this occupation.

20. Instruction Method – example: classroom, correspondence, self paced.

21. Delivery Technique – example: time based (4 yrs., 5 yrs.), competency based obtained from Program’s Standards of Apprenticeship.

22. Instruction Provider – example: community college, adult education, sponsor, etc.

23. Wages paid during RTI? Are apprentices paid while attending classes (Yes or No)?

24. Hours of RTI Provided – The hours of related instruction provided per year.

25. Total Length of Instruction – The hours of instruction (related classroom and on-the-job learning) provided during length of program.

26. RTI Provided By – name of college, adult education, or sponsor.

27.-34. RTI Source Information – Only enter information if there is more than the one RTI Provider identified in Item 26.

35.a-c Self-explanatory.

Reminder that ATR enters data in fields 34 - 66.

36. Apprenticeship and Training Representative (ATR) Name – Self-explanatory.

37. ATR’s RAPIDS Identification Number –alpha-numerical code that identifies the ATR in the RAPIDS database.

38.a Bargaining Agency Name – name of local union, if applicable.

38.b National Affiliation – Union acronym, example: IBEW, SMWIA, etc.

39.a-d Program Type - Enter appropriate numerical code:

a1 = INJ (Independent, non joint = single employer not covered by Collective Bargaining

Agreement.)

b2 = IJ (Independent, joint = single employer covered by collective bargaining agreement.)

c3 = GJ (Group, joint = multi employer association, covered by collective bargaining agreement.

d4 = GNJ (Group, non joint = multi employer association not covered by collective bargaining

agreement.)

40. Number of Participating Employers – Number of employers who are signatories to the standards of apprenticeship for training of apprentices.

41. Self-explanatory.

42. Waiver - Under a joint program (IJ or GJ) where one of the sponsoring parties under a Collective Bargaining Agreement does not wish to participate in the operation of the program and has elected to “Waiver” any rights and privileges under that program.

43. Size of Workforce - Includes all employees, workers, management, clerical, etc.

44.-54. Self-explanatory.

55.a North American Industrial Classification System (NAICS) - formerly, the Standard Industrial Classification (SIC) System. NAICS is a six-digit classification code used to designate industries such as mining, construction, manufacturing to identify the type of the program sponsor’s industrial activities. This code is used by government entities for statistical purposes.

55.b Employer NAICS Code, NAICS Two-Digit Category, Products/Services.

55.c Products/Services – a short written description of the products/services that the sponsor provides.

56.a-b Apprenticeship Committee Exists (Yes/No).

57. Membership List Attached (Yes/No).

58. Occupational Title - example: carpenter, plumber, sheet metal worker, etc.

59. RAPIDS Code – alpha-numeric code of occupation in RAPIDS database.

60.a Apprenticeship Term - Number of Hours: length of apprenticeship in hours.

61.a. Probation Length in Hours - Number of Hours: length of probation in hours, example: 3 months equals 500 hours; 6 months equals 1,000 hours).

62. Written School-to-Apprenticeship (STA) Agreement – Sponsor has an agreement that would be signed by the high-school student, parent, school, employer or employer's agent.

63. Prison Indicator (Yes or No) – Sponsor has an agreement with a prison system for training inmates.

64. Affirmative Action Plan (Yes or No).

65. Selection Procedures (Yes or No).

66. Wage Record Schedule - Multiple wage schedules may apply to a program that has the same occupation in different geographic localities. The wages are based on the prevailing wage rates and fringe benefits determined by the Secretary of Labor for inclusion in covered contracts.

66.a. Includes Four Wage Schedules.

66.b Increment Type – Is wage advancement based on percent or hours of journeyperson’s wage.

66.c Start Date – Date program is registered. Enter today’s date.

66.d Apprentice Entry Wage Rate (Hour, Month, Year) – Apprentice’s current wage today.

66.e Journeyworker Wage Rate – Wage in hours, monthly, or annually at apprentice completion of program obtained from Program’s Standards of Apprenticeship.

66.f Number of Periods – Each period is a specific length of time to acquire a specific skill which is obtained from the Program’s Standards of Apprenticeship.

67. Program Registration Date (Significant Date) – RAPIDS database generates this data.

68. Last Program Revision Date (Significant Date) – RAPIDS database generates this data.

69.a-c Self-explanatory.

Public Burden Statement – Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Public reporting burden for this collection of information is estimated to average ten minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond is required to obtain or retain benefits under 29 USC 50. Send comments regarding this burden or any other aspect of this collection of information including suggestions for reducing this burden to the U.S. Department of Labor, Office of Apprenticeship, 200 Constitution Avenue, N.W., Room N-5311, Washington, D.C. 20210 (Paperwork Reduction Project (1205-0223).

Page 3 of 4 ETA 671 – Section I (Rev. April 2009)