Annexure-

APPRENTICES CONTRACT REGISTRATIONCARD

[Under Section 4 of The Apprentices (amendment) Act, 1961]
(Must be submitted in triplicate within ten days from the date of joining along with a copy of final year / final semester mark sheet
authenticated / verified by the employer with seal of employer)
In Case, Apprentice has joined the establishment Boards Sponsoring Letter Number Apprentice PID Number
directly mention “DIRECT”
BT/AA-
[To be filled by BOAT(NR)] Important
a) Graduate Apprentice (GA) Registration No.: Affix firmly a recent
[Engg./Tech. Degree passout] passport size
b) Graduate Sandwich Apprentice (GSA)
Reg. Date: photograph and put
[Engg./Tech. Degree student]
c) Technician Apprentice (TA) D D M M Y Y Y Y
employer’s signature
[Engg./Tech. Diploma passout] and organization’s seal
d) Technician Sandwich Apprentice (TSA) Registered Under Section 4 of The so that they appear
[Engg./Tech. Diploma student] Apprentices Act. partly on photograph &
e) Technician Vocational Apprentice (TVA) ACRC
[10+2 Vocational passout] Do not pin or staple
1. Gender

Male Female REGIONAL /DEPUTY / ASSISTANTCENTRAL

APPRENTICESHIPADVISER
2. Date of BOARD OF APPRENTICESHIPTRAINING (N.R.)
D D M M Y Y Y Y
Birth

3. Name of the Apprentice (in capital letters as in mark sheet) 4. a) Father’s Name

4. b) Mother’s Name
(First Name)                           (Middle Name)(Last Name) (First Name)    (Middle Name)(Last Name)
5. Address (a) Permanent Address (b) Present Address (c) Whether belongs to:please specify [ √ ]
House/Plot No.
General Schedule Caste
Street
Schedule TribeOther Backward Class
Village
Block/Tehsil Minority Community: Muslim Jain Parsi
District Christian Sikh Other
Pin Code Physically Handicapped
Telephone Number: Mobile Number: Email ID:

6. Educational
Qualification
Degree / Name of the Name of the Institution, Discipline Month University/ %of 10th& 12th /
Diploma / University / City & State / Branch & Year BoardEnrollm Marks Diploma
10+2 (Voc) Board of ent No. / or Registration
Passing RollNo. CGPA No. / RollNo.

7.Period of training: 8.Rate of Stipend

Commencement date*End date (in Rs. per month)
D D M M Y Y Y Y
D M M Y Y Y Y
D
*Note: Date of commencement of training must be after date of declaration of result
9. Name & Address of the Employer 10. Name & Address of the Surety.

Pin Code : Pin Code :

Phone No : Phone No :
Fax No : Fax No :
E-mail id : E-mail id :
Note: 1. This Contract Registration Card must be submitted with both pages appearing back to back and not on separate sheets.
2. This Contract Registration Card is liable for rejection in case any information in any clause is not furnished / partly furnished.
We, the Employer, Apprentice (the Guardian in the case of a Minor Apprentice), and the Surety hereby declare that we have read
the contents of this Apprenticeship Contract as per The Apprenticeship Rules, 1992, as amended from time to time, and agree to
abide by all the provisions made there under. We also declare that all the provisions of The Apprentices Act, 1961, as amended
from time to time including those relating to Payment of Stipend, Registration of Contract, Claim for reimbursement of Government
Share of 50% limited to Government minimum rates prescribed from time to time, and Termination of Contract, etc. are binding on
us. We also understand that training under The Apprentices Act “do not guarantee a job with the employer / BOAT after the training
is completed”.
1. In the event of termination of Contract through failure on the part of the Employer to carry out the terms and conditions of the
contract, he/ she shall pay to the Apprentice such compensation as may be provided by the Central Govt.
2. In the event of termination of Contract through failure on the part of the Apprentice to carry out terms of the contract, the
Surety at the request of the Apprentice hereby guarantees to the Employer and the Central Government the payment of such
amount as may be determined by the Central Apprenticeship Adviser, towards the cost for training of the Apprentice.
3. The liability of the Surety shall not at any time exceed an amount equal to Rs.2500 with interest at 12% per annum.

Note: The stipend shall be compulsorily paid by the Employer to the Apprentices for a
particular month by the 10th day of the following month.
 

Signature of Employer, and                         Signature of Apprentice                       Signature of Surety

Seal of Establishment                               or Guardian (in case of a minor Apprentice)

Witness: 1...............……........................     Witness: 1......………..............................  Witness: 1...............…....................

(Name__________________________) (Name___________________________) (Name_____________________)

2.................…………………… 2 ……...................................... 2.........….........................

(Name__________________________) (Name___________________________) (Name_____________________)

SELF DECLARATION
(To be obtained from the candidate before joining as an Apprentice)
I ______________________ son / daughter of ________________________________________________________________
aged _____________________ residing at ___________________________________________________________________
____________________________________________________________ hereby solemnly affirm and state as under:
1. That I passed my Degree / Diploma / 10+2 Vocational Higher Secondary Certificate examination in (Subject)
_________________________________from __________________________________________ Polytechnic / College / School
at (Place) _________________________________. The date of declaration of my Final year result is _________________
2. That after passing the above said examination
a. I did not have training or job experience for one year or more.
b. I did not undergo apprenticeship training at any place under The Apprentices Act.
What is stated above is true to the best of my knowledge and belief, and nothing has been concealed therein. I am well aware of
the fact that if the information given by me is proved false/not true, I will have to face the punishment as per the law. Also, all the
benefits availed by me shall be summarily withdrawn.

Date:
Place:                                                                                                                     SIGNATURE

CHECK LIST FOR EMPLOYERS

Apprentices Contract Registration Card (ACRC) is in a ‘Self-Declaration’ is duly furnished and signed by the Apprentice.
proforma as prescribed by BOAT (NR), Kanpur.

Photograph of the Apprentice bears signature of employer with seal of The photocopy of mark sheet of Final Year / VIII th Semester of
establishment, both partly appearing on the Contract Registration Engineering Degree / VIth Semester of Diploma / 12th Vocational
Card as well. authenticated by the officer of the establishment by signing and
affixing seal, is enclosed. (Copy of marksheet downloaded from
internet is not acceptable).

All columns /details required in ACRC form are duly filled in. The Apprentice has passed all the semesters/exams of the
Engineering Degree / Diploma Course / Vocational course.

Employer’s ‘Seal’ is affixed on the Contract Registration Card. ACRC is signed by the Employer, Apprentice, Surety and the
Witnesses.