ITA Customer Service
800 - 8100 Granville Ave
Richmond, BC V6Y 3T6
Tel: 778-328-8700
Fax: 778-328-8701
Toll Free: 1-866-660-6011
Page 1 of 1 The Industry Training Authority is an agency of the Government of British Columbia. January 2016
CS005.4 Work-Based Training Report
This form is used by employers / sponsors to report work-based training hours for an apprentice in any program. Missing information
may delay the reporting process.
A. Apprentice Information Please print clearly and return form to the address noted above
ITA Individual ID #:
Program (Trade) Name:
*Legal First Name:
Legal Middle Name (s):
*Legal Last Name:
*Date of Birth (MM/DD/YYYY):
Email Address:
B. Work-Based Training Hours Reporting Period
Ensure exact start and end dates are reported
Total number of work-based training hours reported during
this period.
Start Date: ___________________
End Date: ___________________
Do not overlap any hours on this report with hours sent in previously.
Note: We are unable to accept future dates for hours apprentices have not
yet worked.
C. Employer / Sponsor Approval
Were these hours worked for a previous/alternate employer?
Yes (Employer Name Required) No
Previous/Alternate Employer Name:
Sponsor Organization Name:
Name of Authorized Sponsor Representative:
Sponsor Organization ID#:
Signature of Authorized Sponsor Representative:
“I attest that the work-based training completed by the above named trainee/apprentice is being done under the
supervision/direction of a certified tradesperson or equivalent.
The signature of the apprentices registered sponsor or an authorized representative is required. Without it,
the work-based training hours claimed in this report will not be added to the apprentice’s record.