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	Apprenticeship Qualifications | Entry Level Apprentice Program | Journey Level Apprentice Program Journey Upgrade Program | Program Application ABOUT THE PROGRAM Program Application *Last Name: *First Name: *Email: *Phone #: *Street Address *City *County *State/Provence *Zip Code Have you ever been indentured in this program or any other trade? ---- Select One ---- Yes No If YES, please list indenture date: Reason for removal: Do you have a valid California Driver License? ---- Select One ---- Yes No If YES, please list expiration date: Do you have a standard multi-media first aid certificate? ---- Select One ---- Yes No If YES, please list issue date: What is the highest school grade level you have completed? ---- Select One ---- 1-6 7-8 9 10 11 12 Associates Degree Bachelor's Degree Please choose your ethnicity: ---- Select One ---- Filipino Hispanic Indian American Asian Black Other Non-White Non-Minority Please choose your sex: ---- Select One ---- Female Male *Required fields Northern California Surveyors Joint Apprenticeship Committee respects your desire for privacy. Personal information collected from this form will not be shared with organizations external without your consent, except to process data on our behalf in connection with this application. We will only use your personal information for communications regarding your request. For more information, please read our privacy policy.
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