APPRENTICES CONTRACT REGISTRATION CARD MANUAL SUBMISSION Apprentice Blank Form

MANUAL_SUBMISSION_%20Apprentice%20Contract%20Registration%20Blank%20Form

MANUAL_SUBMISSION_%20Apprentice%20Contract%20Registration%20Blank%20Form

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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)
a) Graduate Apprentice (GA)
b) Technician Apprentice (TA)
c) Graduate (Sandwich) Apprentice (GS)
d) Technician (Sandwich) Apprentice (TS)
e) Technician (Vocational) Apprentice (VOC)
Important
Affix firmly a Recent
Passport Size Photograph
and put employer’s
signature and
organizations seal so that
they appear partly on
photograph & ACRC
[To be filled by BOAT(WR), MUMBAI]
Registration No.:
Reg. Date:
D
D
M
M
Y
Y
Y
Registered Under Section 4 of The
Apprentices Act.
REGIONAL CENTRAL APPRENTICESHIP
ADVISER
BOARD OF APPRENTICESHIP
TRAINING (W.R.), MUMBAI
1. Gender
Male Female
2. Name of the Apprentice (in capital letters as given in examination mark sheet)
(Last Name) (First Name) (Middle Name)
3. (a) Permanent Address
Pin Code:
(b) Present Address
Pin Code:
(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
(Specify minority Community)
Physically Handicapped Yes No
Telephone No : Mobile No :
4. Date of Birth
D
D
M
M
Y
Y
Y
Y
Email :
5. Qualifying Examination for
apprenticeship training
[Degree / Diploma / HSC (Voc)]
Name of
the
University
/ Board
Discipline / Branch
Date of
declaration of
result
Exam Seat No.
6. Date of commencement of
Training*
D
D
M
M
Y
Y
Y
Y
Period of training:
From
D
D
M
M
Y
Y
Y
Y
To
D
D
M
M
Y
Y
Y
Y
Rate of stipend
`
*Note: Date of commencement of training must be after date of declaration of result
7. Name & Address of the Employer
Pin Code :
Phone No :
Fax No :
E-mail id :
8. Name & Address of the Surety.
Pin Code :
Phone No :
Fax No :
E-mail id :
Note:
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.
Do not pin or
staple
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 Signature of Apprentice Signature of Surety
Seal of Establishment or Guardian (in case of a minor Apprentice)
Witness: 1...............……........................ Witness: 1......……….............................. Witness: 1...............…....................
(Name__________________________) (Name___________________________) (Name_____________________)
2.................…………………… 2 ……...................................... 2.........….........................
(Name__________________________) (Name___________________________) (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 Declarationis 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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