APPRENTICES CONTRACT REGISTRATION CARD MANUAL SUBMISSION Apprentice Blank Form
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APPRENTICES CONTRACT REGISTRATION CARD [Under the Section 4 of The Apprentices (amendment) Act, 1961] (Must be submitted within one month from the date of joining along with a copy of final year mark sheet authenticated with seal by the employer) [To be filled by BOAT(WR), MUMBAI] a) Graduate Apprentice (GA) Registration No.: Important b) Technician Apprentice (TA) Affix firmly a Recent Passport Size Photograph c) Graduate (Sandwich) Apprentice (GS) and put employer’s Reg. Date: signature and d) Technician (Sandwich) Apprentice (TS) D D M M Y Y Y Y organization’s seal so that Registered Under Section 4 of The e) Technician (Vocational) Apprentice (VOC) they appear partly on Apprentices Act. photograph & ACRC Do not pin or staple 1. Gender Male REGIONAL CENTRAL APPRENTICESHIP ADVISER BOARD OF APPRENTICESHIP TRAINING (W.R.), MUMBAI Female 2. Name of the Apprentice (in capital letters as given in examination mark sheet) (Last Name) 3. (a) Permanent Address (First Name) (b) Present Address Pin Code: (Middle Name) (c) Whether belongs to: General Yes No Schedule Caste Yes No Schedule Tribe Yes No Other Backward Class Yes No Nomedic Tribes Yes No Minority Community Yes No Pin Code: (Specify minority Community) Physically Handicapped Telephone No : Yes No Mobile No : 4. Date of Birth D Email : 5. Qualifying Examination for apprenticeship training [Degree / Diploma / HSC (Voc)] D M M Y Y Y M M Y Y Date of declaration of result Discipline / Branch Y Y Y Exam Seat No. Period of training: From 6. Date of commencement of Training* D Name of the University / Board D Rate of stipend D D M M Y Y Y Y D D M M Y Y Y Y To ` *Note: Date of commencement of training must be after date of declaration of result 7. Name & Address of the Employer 8. Name & Address of the Surety. Pin Code Phone No Fax No E-mail id Note: : : : : Pin Code Phone No Fax No E-mail id : : : : 1. This Contract Registration Card must be submitted with both pages appearing back to back and not on separate sheets. 2. This Contract Registration Card is liable for rejection in case any information in any clause is not furnished / partly furnished. We, the Employer, Apprentice (the Guardian in the case of a Minor Apprentice), and the Surety hereby declare that we have read the contents of this Apprenticeship Contract as per The Apprenticeship Rules, 1992, as amended from time to time, and agree to abide by all the provisions made there under. We also declare that all the provisions of The Apprentices Act, 1961, as amended from time to time including those relating to Registration, and Termination of Contract, are binding on us. We also understand that training under The Apprentices Act do not guarantee a job with the employer/BOAT after the training is completed. 1. In the event of termination of Contract through failure on the part of the Employer to carry out the terms and conditions of the contract, he/ she shall pay to the Apprentice a compensation of an amount equivalent to three months of minimum stipend payable under The Apprentices Act. 2. In the event of termination of Contract through failure on the part of the Apprentice to carry out terms of the contract, the Surety at the request of the Apprentice hereby guarantees to the Employer and the Central Government the payment of such amount as may be determined by the Central Apprenticeship Adviser, towards the cost for training of the Apprentice. 3. The liability of the Surety shall not at any time exceed an amount equal to three months of minimum stipend payable under The Apprentices Act. Note: The stipend shall be compulsorily paid by the Employer to the Apprentices for a particular month by the 10th day of the following month. Signature of Employer, and Seal of Establishment Signature of Apprentice or Guardian (in case of a minor Apprentice) Signature of Surety Witness: 1...............……........................ (Name__________________________) Witness: 1......……….............................. (Name___________________________) Witness: 1...............….................... (Name_____________________) 2.................…………………… (Name__________________________) 2 ……...................................... (Name___________________________) 2.........…......................... (Name_____________________) SELF DECLARATION (To be obtained from the candidate before joining as an Apprentice) I ______________________ son / daughter of ________________________________________________________________ aged _____________________ residing at ___________________________________________________________________ ____________________________________________________________ hereby solemnly affirm and state as under: 1. That I passed my Degree / Diploma / 10+2 Vocational Higher Secondary Certificate examination in (Subject) ______________________________________________from ____________________________________________________ Polytechnic / College / School at (Place) ____________________________________. The date of declaration of my Final year result is _________________ 2. That after passing the above said examination a. I did not have training or job experience for one year or more. b. I did not undergo apprenticeship training at any place under The Apprentices Act. What is stated above is true to the best of my knowledge and belief, and nothing has been concealed therein. I am well aware of the fact that if the information given by me is proved false/not true, I will have to face the punishment as per the law. Also, all the benefits availed by me shall be summarily withdrawn. Date: Place: SIGNATURE CHECK LIST FOR EMPLOYERS Apprentices Contract Registration Card (ACRC) is in a proforma as prescribed by BOAT (WR), Mumbai. ‘Self Declaration’ is duly furnished and signed by the Apprentice. Photograph of the Apprentice bears signature of employer with seal of establishment, both partly appearing on the Contract Registration Card as well. The photocopy of mark sheet of VIIIth Semester of Engg. Degree course / VIth Semester of Diploma Course authenticated by the officer of the establishment by signing and affixing seal, is enclosed. (Copy of marksheet downloaded from internet is not acceptable). Mention of SC / ST / OBC / Minority / PH / Woman is made for the apprentice The Apprentice has passed all the previous semesters of the Engg. Degree / Diploma Course. Employer’s ‘Seal’ is affixed on the Contract Registration Card. ACRC is signed by the Employer, Apprentice, Surety and the Witnesses.
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