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Pro -1 -n r "fp L Q -CI � "'�' fab�affolq -lid
<br />Apprerniceshfp I'k9re-ement
<br />OMG�e ofAppFentfcastilp
<br />.APIPPW�4171r-z-
<br />Wamfngina� vijra"nnnt do ei not wmirkIUT.6o a mi�W&Mlon wmdorlj'fik�,
<br />W-R, PaC, 6 for M 6 emip@oymauk On Fo6wily M-411ced
<br />aesi'vDa-d r-ansfruejoa Projeo-&- (-'ulront wriffiva"HDOS anmt be obfahl
<br />from ffzf-% Unce- Of '4'prerrhk'whd,� (DA-) or ffi's rmmsnted wh
<br />Name (Last, FIrst, Wldk--) apt.1 AdriFf?SS 'Si�. 'wi
<br />7-
<br />(No., ,Street, City, State, 7jp Gode,
<br />k
<br />Y.
<br />DatL, of Hirdi (Mo., Day, Yr) a Sax (Mark one)
<br />of Labor Department
<br />cmployment and -Eral iing Admirtsfrarion
<br />TF 1206-0, 2; - ?3
<br />-Illsprogioni, sponsor and appP4T&-F" agres to tha tw-jrnz of tta Appirpritr
<br />as part of 'Hu Agraarnent Tffiarponuor loll not crj,wr jjiftinp
<br />in Me selertirm and Wining o-f the appienUm rn ar-cofdama v&h -the- Fqu
<br />Opportunibr -Siandardo- hi ITIP 29 GFR Fart 30, and E-y-arxifiva Onfer 'I'l-246, I-r
<br />al Mu lunk"fraffun aurmw'v. In Tifln'2P- (PR- Pm4 xs
<br />-Answer Both A and B (ifoluntan))
<br />Qv�fmffcns on reverse)
<br />a- Ethnic soup ip (Maria on,)
<br />flibparfiG or-C.a.ffno
<br />t�tl Hispanic. or Ltatio
<br />35. vpfpMIfl 'St-alus 4Maric One)
<br />F --duantion Level (Uarkorja)
<br />FT8khrT—'4eo T--
<br />0 to 'I 2-h� grade,
<br />L I Amm-cari-Indim or Alaska native
<br />Asian Cgrl
<br />F31ack ctrAticar,
<br />1'11adwa Ha-mouian OF othf-ar @-RI High 30hool Gmduaye or
<br />pnala Gfafttc�r
<br />Me 1.1 POSt �Sf--'-Qndary or Tecbrrfml
<br />DA110 FJ . . . . . . . . ...............
<br />7A. -Empfaymenf Status a4;Aq- orle)
<br />7b, Careerrnnnection (U2rk one fIns.truc6o.4 nn revemn) 15e�,WIP Ej Pre-Appi-cinficsship f-I IffitaTyVeferano
<br />J-1,fribcorps _L[YOWIBUIld [] HAMWEr-LUP E Gafeer CenteT Rmiarraf
<br />-- ----- - - -------------- . . . . .... . ............. ........... .... ........ . . .
<br />IT
<br />t4 Ap f4,, U V nature uJf'Par-anf(GuaFdPau ffrfl[aor) Data
<br />fI� �SVOM§dk�.- F�"Cl`w FOR ri-E, 'S 6,
<br />7, 9, Ilra� - I
<br />-- ---------- 1. Sponsor Prograu .4
<br />0 1 S'I—() 0
<br />Sparmur Nam and Addrese: (No- Street GIW, Gomyt, Stele, i'ip CWt;)
<br />J T C.
<br />4
<br />31 O'z ffbik"P54-0-PW-A RAM 'Xhf.)N
<br />!a 0,cupaffort fffia mik processes r1sted in 2h 0 x p, ion. Code-- 61, 61
<br />he sfardurilsu-- part ofthis, agreement)- 2b. 1 . Inteft Credentials
<br />Only a,pplicable fo Part D, 3-b-
<br />Enter, Occuqodion land 3.. (A6ark on
<br />eali ST R v ef 4 1) A) LI Y,s U V.
<br />f4� Occupailon Trainvirj �a -j period
<br />one) (FIrs., Mrs-, Ym,) (lim, P&os., Yrs.)
<br />14 q Y I 36. Gumpotomc t&S
<br />3m I �ybrjd
<br />Ramahing 4j,)t6XI;(w �VMO-47 'q." ij?"
<br />B. GrFditfur P03-mous 7- Term
<br />Yr,
<br />Expe6enm (firs., Mos., Im, mm' yhs') IS, ,
<br />............ . . ... ... .. .. ...... ....... . ....
<br />(Number�of vsPerYbar)
<br />Fisk, id jQl� �tit Be Paid
<br />- — ---------------- ---- -- '4a
<br />I I Wages: (Instructions on ramesa)
<br />1-1
<br />0% Pre -Apprenticeship Hour{ Wage I Ob. Apprentice's Entry Hou dy Wage 10 u� J a w - n ey wo rb C-- go ur Iv W; ag s $
<br />. ........... .
<br />2 3 4 5 a 9 10
<br />IPII ks.' LT MOD, or Ely
<br />f0e. 'Nage ILR'rim / i
<br />-�
<br />Y&ik % [Alor $ III
<br />1 -1, SIgnatwi-- of Sponsor's
<br />1Z Ski nature. oflSpons&,q Repre-oontafive(s)
<br />904 . ...........
<br />. Date StgrIE30
<br />Date 21gne4
<br />13. Name andl'Wdress of SponsarDesIgnea to Receive Can, plaintss
<br />- (11"'applicab
<br />&tM<I),YpJ 1171124
<br />I. %1Frqffun Agenc,�y uc[Address Signalurs F18"g]"tmed
<br />t.
<br />... . ........ . ...
<br />4. ApprvliUf,rr rdenliffuiAmi Munfier (Definition on mmisel:
<br />
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