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    • Business/Learning & Development
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Vermont Tech
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Apprenticeship Pre-Registration

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Level 2-4 Apprentices Only

Apprenticeship Related Instruction Pre-Registration Form

"*" indicates required fields

Trade*
Name*
Address
Do you wish to receive important updates and reminders via text message?*
Ethnicity
Legal Sex*
(please provide the name of someone whom we can contact in regards to billing and registration)
Employer Address*
(required for billing purposes)
(required for billing purposes)
Class Schedule (1st Choice)*
Class Schedule (2nd Choice)*
Do you feel you may qualify for learning accommodations?
Are you OSHA Certified?*
(you must have a card to prove certification)
ALL apprentices will be required to participate utilizing a desktop, laptop, or Chromebook with camera, audio, and mic. Please select the device you will be utilizing for class.*
**Please Note: cell phones or tablets are NOT permitted for use during class for the 2021-2022 apprenticeship term**
Please select who will be submitting payment for your 2021-2022 apprenticeship classes:*

Payment Agreement*
I understand that even if my employer is being invoiced for all costs associated with registering for classes, trainings, and/or workshops, I am ultimately responsible, as the student, for these costs. I also understand the terms of the Vermont Tech payment agreement, below:

I understand that I am responsible for all costs associated when registering for classes, trainings and/or workshops.

I understand that if any outstanding balance is not paid when due, I will be blocked from further registrations.

I agree to pay late fees incurred on any unpaid balance.

If this account is not paid when due, I agree to reimburse the Vermont State Colleges System the fees of any collection agency, which may be used on a percentage at a maximum of 33.3% of the debt, interest, and all costs and expenses, including reasonable legal fees, incurred in such collection efforts.

I acknowledge and affirm that this agreement extends to current and future outstanding balances and debts with any of the Vermont State Colleges System institutions.
Please type your name. By doing so, you are agreeing to the terms and conditions of this form.

Questions?

Sarah Ballou
Program Coordinator
Electrical and Plumbing Apprenticeship Programs
sballou@vtc.edu
(802) 728-1680 Office | (802) 661-8493 Cell

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