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DWEA-10407 (R-3/01)
Department of Workforce Development
Division of Workforce Solutions
Bureau of Apprenticeship Standards
EMPLOYER APPLICATION – INDUSTRIAL MANUFACTURING TECHNICIAN
Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m)].
UC Number FEIN Number Date
Street Address or P.O. Box
Indicate appropriate industry group: Construction Industrial Service OJT
Product or Service
Year Business Started Trained Apprentices Before? Yes No
Trade apprentice will be trained in
Are the skilled workers/journey workers in the trade covered by a collective bargaining agreement?
Yes No
If yes, list union name and number
Are the apprentices covered by this agreement? Yes No
Number of skilled workers/journey workers in this trade
Present skilled/journey worker base skilled wage rate per hour for this trade: $ per hour
If the applicant has had previous related school or work experience, how much time credit should be granted
on the indenture?
Work School
Name of school apprentice will attend
Please return to: Long Vang, Dept. Workforce Development, BAS
CVTC
620 W. Clairemont Avenue
Eau Claire, WI 54701-6162
Physical address: CVTC, 2320 Alpine Road, Eau Claire, Wisconsin 54703
MECHATRONICS TECHNICIAN 2019 S:/Manufacturing Campus/Apprenticeship
