Local 250 Joint Journeyman Apprentice Training Center

Journeyman Certification Class Sign-Up Form
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Class Enrollment may also be submitted via mail or walk-in.
All enrollments are subject to quota and eligibility verification.
Notification of acceptance will be forwarded when enrollment is confirmed.

Name (Last, First)*
Street Address*
City, Zip*
Phone*
Cell Phone/Pager
*Social Security# (Please enter the last 4 digits only)**
Employed By:
Email Address:* Please enter an email address. If you do not have email enter: mail@mail.com
* Required Field

NOTE: In compliance with Article VIII, Paragraph 91, your intent to certify must be received in this office by August 31, 2008. (Choose One) I intend to certify by:
* *You may sign-up for a class only if registering for '08-09 Certification Class. All enrollments are subject to quota and eligibility verification.

Class ID:	*
Class Name:
Night:
You must enter the class id number. If the class is full you will be notified when this form is submitted and may choose another class from the list by clicking here.