APPRENTICE REGISTRATION APPLICATION (F1-ARA) …
north carolina State Hearing Aid Dealers and Fitters Board APPRENTICE REGISTRATION APPLICATION (F1-A RA) APPRENTICE and Sponsor Affidavits FOR BOARD USE ONLY: EU _____ AU _____ CM __________ Issue __________ CBG ____________ Fees ___________ F7 ______ F1E _______ SP ____ Cert. # ________________ F1-ARA (Updated Oct. 2012) Note: This affidavit is a part of the electronic APPRENTICE REGISTRATION APPLICATION . All forms, documents, and submissions, as part of the APPLICATION process, are covered by this affirmation. Your electronic APPLICATION will not be processed until this signed affidavit is received by the Board. Date of Electronic APPLICATION (enter date of submission, if known): ______________ Sponsor Name (PRINT CLEARLY): ________________________________________ ______________ License Number: _________ or Registered Sponsor Certificate Number: ____________ APPRENTICE Applicant Name (PRINT CLEARLY): ________________________________________ ___ APPRENTICE Applicant's Social Security Number (PRINT CLEARLY): _____________________________ APPRENTICE Applicant's Date of Birth (mm/dd/yyyy): ______ / _____/ ________ Affidavit: I hereby affirm that I have completed the APPRENTICE REGISTRATION A
North Carolina State Hearing Aid Dealers and Fitters Board APPRENTICE REGISTRATION APPLICATION (F1-ARA) Apprentice and Sponsor Affidavits FOR BOARD USE ONLY: EU ...
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