Fill - Free fillable Form 1.: MEMBERSHIP APPLICATION EMPLOYER/SPONSOR PDF form

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EMPLOYER/SPONSOR

MEMBERSHIP APPLICATION

2. Contact Information

Is the owner a member of the Ontario College of Trades?

Yes

If Yes, what is their membership number?

First Name Middle Name or Initial Last Name

Preferred Language English French

Street Number

Business telephone number (self employed)

Unit Number

PO Box

Country

Postal Code

Province

City / Town

The information provided in or in connection with this application is collected, used and disclosed under the authority of the Ontario College of

Trades and Apprenticeship Act, 2009 (OCTAA), the Regulations under the OCTAA, the College’s by-laws, and other applicable laws or regulations.

Street Name

Business Address

Ontario College of Trades

655 Bay Street Suite 600

Toronto, Ontario M5G 2K4

Telephone: 416-673-6524

Toll free: 1-855-299-0028, Fax: 1-647-348-5002 E-mail:

membership@collegeoftrades.ca HST NO: 839542511RT

18-07-2017 ES-

MEMBER_APPLICATION_CON_V2.0.0_EN_MS-MR_18-07-2017

MTCU Client ID (Sponsors only)

Legal Business Name

Operating as (if applicable)

Employed Trades by Trade Code

Information for Employers/Sponsors - Information

Ontario Business Identification Number (BIN)

Email Address

No Yes If Yes, provide details.

No Yes

If Yes, provide details.

3. Background

In the following questions, “you” refers both to an individual and to any corporation, partnership, proprietorship, or other organization used by

an individual (alone or with others).

If you answer “Yes” to any of the following questions, please provide full details, including particulars, dates, results, outcomes, and

supporting documents (if you need more space, please attach an extra page).

Have you ever had investigations proceedings or actions commenced against you by an apprenticeship or trades organization, regulatory or self-regulatory

body in Canada or elsewhere, in relation to discipline, misconduct, incompetence, or incapacity?

Have you ever been refused membership, a licence, or a permit from an apprenticeship or trades organization, regulatory or self-regulatory body in Canada

or elsewhere, on the grounds of discipline, misconduct, incompetence, or incapacity?

Have you ever had your membership, licence, permit or training agreement issued by an apprenticeship or trades organization, regulatory or self-regulatory

body in Canada or elsewhere, revoked, suspended, or made subject to specified terms, conditions or limitations on the grounds of discipline, misconduct,

incompetence, or incapacity?

Have you ever, as a member or holder of a licence, permit or training agreement of an apprenticeship or trades organization, regulatory or self-regulatory

body in Canada or elsewhere, been reprimanded, admonished, fined, found guilty of an offence, received counselling, required to perform training or

course of study, subject to any other remedial measures, or resigned, on the grounds of discipline, misconduct, incompetence, or incapacity?

As a note to all applicants, please be reminded that the College takes reasonable steps to verify information provided in support of any application. Applicants are responsible

for ensuring the accuracy and validity of all information provided. During the assessment of an application, or at any later date, if the College determines that false, misleading

or incorrect information was provided, an application may be cancelled, revoked and/or refused. Additionally, if it is found that anyone attesting to an applicant’s trade

qualifications and/or experience has provided false or misleading statements of any kind, further consequences under the Ontario College of Trades and Apprenticeship Act,

2009, with fines of up to $10,000 may apply.

ganisation Size

0-50 Employees

51-100 Employees

101-500 Employees

501-1000 Employees

over 1000 Employees

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I consent that all information, documents or records requested by the College for the above-noted purposes from other sources may be provided to the College.

In addition, I consent that the College may collect, use and disclose my personal information and confidential information provided in or in connection with this application as

provided above, as well as in accordance with the College’s privacy policy available at http://www.collegeoftrades.ca/privacy and as permitted or required by applicable laws or

regulations.

The information provided in or in connection with this application is collected, used and disclosed under the authority of OCTAA, the Regulations under the OCTAA, the College’s

by-laws, and other applicable laws or regulations.

I consent that the College may collect, use and disclose any information provided in or in connection with this application for the following purposes:

• verifying the information;

• processing this application;

• administering my file or membership with the College;

• administering and enforcing the OCTAA, the Regulations under the OCTAA, and the College’s by-laws;

• conducting inspections or investigations;

• conducting policy analysis, evaluation and research related to apprenticeship and trades certification;

• any other purpose for which the College requests your consent and to which you consent;

• as required or permitted by law

4. Declarations of Accuracy and Consents for Application

Certification of Accuracy of Information Provided

I declare that by signing below, all information I have provided or

will provide to the Onta

rio College of Trades (the “College”)

the

future

conne

ion

with

thi

application

is true,

accurate

and

complete. I agree

to immediately notify

the College regarding any future changes to information I have provided.

I acknowledge that if I provide false or misleading information or documents to the College, or fail to provide information or documents requested by the

College:

• I ma

y be denied a Certificate of Qualification, Provisional Certification of Qualification, or a Statement of Membership;

any Certificate of Qualification, Provisional Certificate of Qualification, or a Statement of Membership issued by the College to me may be suspended, revoked, or made

subject to specified terms, conditions or limitations;

I may be guilty of an offense and on conviction liable for a fine; or

I may be subject to other proceedings, penalties, costs, or consequences under the Ontario College of Trades and Apprenticeship Act, 2009 (the “OCTAA”), the Regulations

under the OCTAA, and the College’s by-laws, including but not limited to, professional misconduct proceedings which could result, if I am found guilty, in a range of

penalties, including an order directing the Registrar to revoke, suspend or impose terms, conditions or limitations on any Certificate of Qualification, Provisional

Certificate of Qualification, or Statement of Membership which the College may issue to me.

• my current and former employers;

• government

atio

(

including departments, boards and agencies) or officials, police forces or military autho

rities;

•

governing, regulatory, self-regulatory, apprenticeship or trades bodies, authorities, agencies or officials;

• educational inst

itutions;

• consumer

reporting agencies;

• publicly available sources under applicable laws or regulations;

• any

other

relevant sources.

For staff use only- do not write in this section

Entered into TMS

Staff name:

Staff signature:

Date:

(mm/dd/yyyy)

Consent

I consent that the College may for the purposes of the administration of the OCTAA contact, request information, documents or records from, and provide information to, other

sources including:

•

18-07-2017 ES-MEMBER_APPLICATION_CON_V2.0.0_EN_MS-

MR_18-07-2017

Date (mm/dd/yyyy)

Signature





I am attaching a cheque or money order to cover fees or,





I authorize the use

the following credit card to cover

fees as foll

ows:

Credit Card

Payment Type:  Visa 

 Mastercard

 American Express

Credit Card Number:

Expiry Date:

BBBBBBBBBBBB

(mm/yyyy)

Print Cardholder's Last Name:

First Name:

Signature of Cardholder: Date signed: _______ / _______ / _______

(mm/dd/yyyy)

Payment Processing (Note: All payments to be made payable to

the Ontario College of Trades)

Type of payment:

0HPEHUVKLSIHH: $135.60 ($120.00 +HST)

For you protection please do not Email credit card

information. For Credit Card payments call or fax

to the numbers at the top of this form.

Individual members holding more than one certificate of qualification or statement of membership will

not have to pay more than one membership fee annually.

an Ontario College of Trades (the College) member, you have the right to have your statements, receipts and communications provided or made available to you through one

of the following methods: electronically through email or paper via postal delivery. By default the College will communicate all statements, receipts and communications

electronically when an email address is provided. At any time you may change the delivery method of your statements, receipts and communications by logging into your member

account through our online portal or by contacting our Client Service Department at 416-673-6524 or 1-855-299-0028.

By checking this box, I hereby request that the Ontario College of Trades send my statements and receipts by postal mail rather than email.

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Fillable Form 1.: MEMBERSHIP APPLICATION EMPLOYER/SPONSOR

Fill Online, Printable, Fillable, Blank Form 1.: MEMBERSHIP APPLICATION EMPLOYER/SPONSOR Form

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