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

organization’s 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

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 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.