STATE OF IDAHO DIVISION OF OCCUPATIONAL & PROFES IONAL LICENSES

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STATE OF IDAHO DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSES PO BOX 83720 Boise, ID 83720-0063 Ph: 208-334-3950 Website: dbs.

Email: customer-service@dopl.

APPLICATION FOR HVAC APPRENTICESHIP REGISTRATION

Idaho Statutes and Rules are subject to change and it is the registrant's responsibility to ensure they have read and understand the requirements to do HVAC work in Idaho. Idaho Statutes and Rules can be found online at: .

To qualify for an HVAC Apprentice Registration, an applicant must: ? Be 18 years of age OR o Submit proof of registration as an Apprentice from the U.S. Department of Labor? Office of Apprenticeship. o Employed by an HVAC Contractor that is an approved STRAP provided and have completed the STRAP Addendum agreement with ID Department of Labor. ? Submit a complete and notarized application (included). ? Fulfill the requirements of IDAPA 24.39.70.020 and IDAPA24.39.70.025 (see below) ? Provide a Social Security Number in accordance with Idaho Statute 73-122. ? Provide a copy of legal identification (Driver's License, Passport, Military I.D.) ? Pay the $10.00 (non-refundable) registration fee

IDAPA 24.39.70.025 HVAC APPRENTICE REQUIREMENTS FOR REGISTRATION

01. Registration. To become an apprentice, a person shall comply with Section 54-5012, Idaho Code, and be a minimum of eighteen (18) years of age or sixteen (16) years of age if registered by the Bureau of Apprenticeship and Training of the United States Department of Labor. To renew a registration, an apprentice shall show proof of enrollment in a Board-approved training course or completion of eight (8) hours of Board-approved continuing education for each year of the prior registration period.

02. Supervision. Each apprentice must work under the supervision of a certified HVAC journeyman.

This application can emailed to customer-service@dopl. with the attached credit card authorization.

Questions? Email tradelicensing@dopl.

H-APPR APPL

1

07/13/2022

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STATE OF IDAHO DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSES PO BOX 83720 Boise, ID 83720-0063 Ph: 208-334-3950 Website: dbs.

Email: customer-service@dopl.

APPLICATION FOR HVAC APPRENTICE REGISTRATION YOU MUST PROVIDE A COPY OF LEGAL IDENTIFICATION (Driver's license, Passport, Military ID)

Are you currently serving in the US military, a veteran or spouse of any such person? Yes _____ No _____

Applicant's Legal Name: _____________________________________________ Date of Birth:___________

Mailing Address: ______________________________________________________________________________

City: _____________________________________________ State: _____________ Zip Code: ______________

Social Security Number:________________________________________________________________________

Contact Phone Number(s):____________________________________________________________________

E-Mail Address:_______________________________________________________________________________

(All future notifications will be done via email.)

Employer (if under 18 & enrolled in STRAP agreement): _______________________________

Please be advised that the DOPL shall consider the address provided by the applicant on this form as the business address of record for the applicant, which may be subject to public disclosure in accordance with the Idaho Public Records Act (I.C. ?101 et seq). Because the address will be used for the purposes of all correspondence from the DOPL with the license/registration holder, please be sure to provide an address that will be accurate for the duration of license or registration period. By providing this application the successful applicant acknowledges that upon request DOPL may disclose the address as a public record, and the applicant provides his/her consent to do so.

I also hereby authorize the Idaho Division of Occupational & Professional Licenses to release the last 4 (four) numbers of my Social Security Number for verification purposes.

I certify the information above is correct and acknowledge I have read and understand the Idaho HVAC apprentice requirements in IDAPA 24.39.70.025.

*Signature:_________________________________________________________ *Date: _________________

THIS SECTION TO BE COMPLETED BY A NOTARY PUBLIC

State of ___________________________________

The above individual appeared before me this ________________day of ____________________________, 20_________

NOTARY SEAL:

__________________________________________________ Signature of Notary Public

Commission Expires: _________________________________

H-APPR APPL

2

07/13/2022

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STATE OF IDAHO DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSES PO BOX 83720 Boise, ID 83720-0063 Ph: 208-334-3950 Website: dbs.

Email: customer-service@dopl. HVAC WORK VERIFICATION FORM

Separate Work Verification Forms are required for each Employer. Separate Work Verification Forms are required for each state in which experience was accrued. Self-verification will NOT be accepted. This form shall be completed when providing experience from out-of-state.

o Please provide copies of any out-of-state licenses (required)

Applicant's Legal Name: ________________________________________ License # if required: _____________

Company Name: _ ________________________________________________________________________

Name of Verifier: ________________________________________________________________________

Address: ____________________________________________________________________________________

City: __________________________________________ State: ______________ Zip Code: _________________

E-Mail Address: _________________________________________Telephone Number:______________________

Dates of Employment: __________________________________________________________________________

From: (month/day/year)

To: (month/day/year)

Description of Work Experience:__________________________________________________________________

________________________________________________________________________

Total hours of work experience: _____________________________________________________________

Was this work done in the State of Idaho? No ________ Yes ________ State_____________________

(If the work was performed in multiple states, a separate verification form is needed for each state. Listed license numbers must reflect the state in which the work was performed.)

I swear (or affirm) under penalty of perjury that the foregoing information is true, complete, and correct.

_____________________________________________________________________________________________

Verifier's Authorized Signature

Date

THIS SECTION TO BE COMPLETED BY A NOTARY PUBLIC

State of _____________________________ The above individual appeared before me this ______________________________day of ______________, 20__________.

NOTARY SEAL: H-APPR APPL

__________________________________________________ Signature of Notary Public

Commission Expires: _________________________________

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2/15/2022

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STATE OF IDAHO DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSES PO BOX 83720 Boise, ID 83720-0063 Ph: 208-334-3950 Website: dbs.

Email: customer-service@dopl.

HVAC APPRENTICESHIP SCHOOL PROGRAMS

Please contact schools for program details

College of Southern Idaho College of Western Idaho College of Eastern Idaho HVACR Education Online North Idaho College Northwest HVAC/R Porter House Inc. ? Shelley Adult Training Academy Porter House Inc. ? Mountain Home Adult Training Academy SE Idaho Sheet Metal JATC SW Central Idaho Sheet Metal JATC SW Idaho JATC Ultimate Heating and Air

(800) 680-0274 (208) 562-3000 (800) 662-0261 (888) 655-4822 option 2 (208) 769-3214 (509) 747-8810 (208) 522-4336 (208) 522-4336 (208) 233-5214 (208) 562-0237 (208) 288-1296 (208) 321-8663

H-APPR APPL

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07/13/2022

CREDIT CARD AUTHORIZATION FORM

Idaho Division of Occupational & Professional Licenses 11341 W Chinden Blvd, Bldg #4 Boise, ID 83714 Phone: 208-334-3950

Email: customer-service@dopl.

I __________________________________________________________, authorize The State of Idaho Division of Occupational & Professional Licenses to charge my credit/debit card account in the amount of $___________________________

*Please note there is an additional 3% charge for the use of your card through Access Idaho.

This payment is for:

License Application Fee ___________________

New Permit Fee ________________________

License Renewal Fee ______________________ Fee Due on Existing Permit ______________

New License Fee _________________________ Other ________________________________

_____________________________________________ Cardholder Signature

______________________________ Date

______________________________________________ Contact Phone Number

________________________________ Email Address for Receipt (optional)

All Fields Below Are Required

Credit/Debit Card Number ________________________________________________________ Expiration Date: _____________/___________ CVC # ____________________ Billing Address Zip Code ________________________

*Your card information will not be retained for future transactions

CC AUTH FORM

6/29/2022

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