Fill out the following form to have your Registered Apprenticeship Program included on the Eligible Training Provider List (ETPL). Please complete one form per occupation you would like to register on the ETPL. Registered Apprenticeship Sponsor Registered Apprenticeship Sponsor Name Federal Employer Identification Number (FEIN) Address Address Address 2 City/Town State/Province - None - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ZIP/Postal Code Website Address Website Address Phone Number Email Address Occupation(s) that are registered with the DOL / Office of Apprenticeship Number of Active Registered Apprentice(s) Disability Access - Select - Yes No ADA Compliant - Select - Yes No Financial Aid Available - Select - Yes No Programs On Another State's ETPL - Select - Yes No Related Training Instruction (RTI) Provider Complete the section below if the Registered Apprenticeship Sponsor does not provide related training instructions for the Registered Apprenticeship Program. Name of Related Training Instruction (RTI) Provider Address of Related Training Instruction (RTI) Provider Address Address 2 City/Town State/Province - None - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ZIP/Postal Code Cost of Instruction Method of Instruction Length of Instruction in Weeks Certification I certify that our Registered Apprenticeship Program may be included on the ETPL and further certify the information contained in this application is true and correct. All supporting documentation is true and factual. Sponsor Name First Name Last Name Sponsor Title Signature Sign above Date Date: Date For questions regarding registration, please contact:Kristopher Byam Registered Apprenticeship Program Coordinator515-725-3663 Contact Form How did you hear about Registered Apprenticeship? How did you hear about Registered Apprenticeship? - None - Recommendation from a friend, colleague, educator, or other IowaWORKS Center IowaWORKS.gov employment website Social Media (LinkedIn, Facebook, Instagram, Twitter) Radio Mission: Employable Podcast Presentation or event (in-person or virtual) from Iowa Workforce Development, IowaWORKS, Registered Apprenticeship or Future Ready Iowa Website or Other... Website or Other... Leave this field blank
