Transcription of APPRENTICE REGISTRATION APPLICATION (F1 …
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APPRENTICE REGISTRATION APPLICATION (F1 …
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 APPLICATION ( APPLICATION ); that I have read and understand the complete APPLICATION ; and that I declare under penalty of perjury, that all of the information, documents, and materials submitted in response thereto are true, cor
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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