www.tvcc.cc · 650 College Boulevard, Ontario, OR 97914 · (541) 881- 8822 Treasure Valley Community College is an equal opportunity educator and employer. Revised 12/12/11

Registration Form Center for Business, Workforce & Community Learning (CBWCL)

_________________________________________ _________________________________ TVCC Student ID -or- Social Security Number* Date of Birth (Required)

_________________________________________ __________________________________________ _________ Last Name First Name M.I.

_________________________________________ ____________________ _________ _________ Permanent Physical Address City State Zip

_________________________________________ ____________________ _________ _________ Mailing Address (if different than above) City State Zip

___________________________ ___________________________ ___________________________ Home Phone Cell Phone Work Phone

_________________________________________ E-mail Address (Required)

Company PO# __________________ (must be presented) Company _______________________________________________

Agency Voucher __________________ (must be presented) Agency _______________________________________________

*Providing your social security number isvoluntary. If you provide it, the college willuse your social security number for keepingrecords, doing research, reporting, extend-ing credit, and collecting debts. The collegewill not use your number to make anydecision directly a*ecting you or any otherperson. Your social security number willnot be given to the general public. If youchoose not to provide your social securitynumber, you will not be denied any rightsas a student. Providing your SSN means thatyou consent to the use of your number inthe manner described.

Persons having questions about or requests for special needs andaccommodations should contact the Disabilities Services Coordinator at Treasure Valley Community College, 650 College Blvd., Ontario, OR 97914. Telephone (541) 881-5812.

CLASSES ADDED: 2021 – 2022 Course # Section Course Title Credits Time Days Instructor Cost

Fall APR 112 A OA INSIDE ELECTRICAL APPR FUNDAMENTALS YR 1 PART 1 4 6 – 9 pm MON.

BlazzardHoward

$950

Winter APR 112 B OB INSIDE ELECTRICAL APPR AC/DC CIRCUIT YR 1 PART 2 4 6 – 9 pm MON Blazzard

Howard

Spring APR 112 C OC INSIDE ELEC APPR MEASURE BLUEPRINT YR 1 PART 3 4 6 – 9 pm MON Blazzard

Howard

CLASSES DROPPED: Subject to CBWCL Policy. Course # Section Course Title Credits Time Days Instructor Cost

Gender:☐ Male ☐ Female

U.S. Veteran? ☐ Yes ☐ No

Citizenship:☐ U.S. Citizen/ Oregon☐ U.S. Citizen/NOT Oregon☐ Not a U.S. Citizen……

High School completed: ☐ Still in high school☐ High School Diploma ☐ GED☐ CIM☐ Proficiency exam ☐ Home school☐ High School Diploma from a Community College☐ External diploma program

Select your ethnicity: ☐ Hispanic / Latino☐ Not Hispanic / Latino

Select your preferred race: ☐ American Indian / Alaskan Native☐ Black / African American☐Native Hawaiian / Pacific Islander☐ Asian☐ White☐ Other

Highest degree level you have completed: ☐ None☐ Other (short term training)☐ 1-Year Certificate☐ 2-Year Associate Degree☐ Bachelor's Degree☐ Master's Degree☐ Ph.D./Professional Degree

Marital Status: ☐ Divorced / Separated☐ Married☐ Single☐ Widowed

Primary reason for attending TVCC: ☐ Take transferrable classes☐ Learn skills to get a job☐ Improve job skills☐ Explore Career / Academics☐ Take classes to earn HS diploma / GED☐ Improve reading/writing/math skills☐ Learn English Language☐ Personal Interests / enrichment☐ Other: ________________________________

By signing this registration form, I agree to pay all tuition and fees applicable to the courses registered for above. Charges are subject to change at any time before the start of an academic quarter. The current charges can be found in the most recent printed class schedules, and on the college website. Whether or not any court action is involved, all expenses, fees, attorney fees and actual collection costs incurred by TVCC in an attempt to collect funds due shall become a part of the unpaid principle balance and payable upon demand. When expenses, fees and collection costs become a part of the unpaid principle balance, I understand my debt to TVCC may double. In the event legal action is instituted for the collection of this debt, the prevailing party shall be entitled to recover, at trial and on appeal, reasonable attorney fees and costs.

______________________________________ Student Signature

_____________ Date

______________________________________ Advisor Signature

_____________ Date

Student Consumer Information: Treasure Valley Community College complies with the Student-Right-to-Know Act, Campus Security/Clery Act of 1990 and Equity in Athletics Disclosure Act. For information or complete reports concerning graduation, completion, and transfer-out rates, the annual campus security report, athletic program participation rates and ,nancial support data, and the college’s policy concerning drug and alcohol abuse prevention, please visit http://www.tvcc.cc/about_tvcc/index.cfm.

Treasure Valley Community College Center for Business Workforce & Community Learning

650 College Blvd. | Ontario, OR 97914 541.881.5755 | cbwcl@tvcc.cc

S:\Shared\Center for Business, Workforce and Community Learning\CBWCL Apprenticeship Programs\CBWCL Electrical APR\Electrical Apprenticeship 2021-2022\REGISTRATION PACKET

2021 YR 1 Electrical Apprentice Checklist

☐ Registration Form

☐ Payment of $950 due upon registration

☐ Student Information Form

☐ Payment for Mike Holt Capacitor/Book Fees (Capacitor/Book fees will be $200 plus shipping and

handling.)

☐ Submit application for Agile Homes Scholarship

☐ Provide Copies of: (Required)

☐ Current Apprentice Card(s) - Oregon and/or Idaho – Apprentice needs to have apprentice

card for state(s) they are working in

☐ Driver’s License or Photo ID

☐ High school or College Transcripts providing proof of High School or higher Algebra

pass/completion

☐ Purchase National Electrical Code and Delmars Standard Book of Electricity

☐ Release of Information – fill out this form for TVCC to release information to your employer or

others (i.e. spouse, parents, etc.)

Treasure Valley Community College

Center for Business Workforce & Community Learning 650 College Blvd. | Ontario, OR 97914

541.881.5755 | cbwcl@tvcc.cc

S:\Shared\Center for Business, Workforce and Community Learning\CBWCL Apprenticeship Programs\CBWCL Electrical APR\Electrical Apprenticeship 2021-2022\REGISTRATION PACKET\Student Information Form.docx

Please provide the following information for our records

Student Name: ________________________________________________________________

OREGON Apprentice # __________________ IDAHO Apprentice #: ___________________

Student Phone Number: ________________________________________________________

Student Cell Phone Provider: ____________________________________________________

(this will be used to send you a text message to ensure delivery of important messages)

Student Address: ______________________________________________________________

______________________________________________________________________________

Employer: __________________________________ Phone: ___________________________ Business Name Business Phone

Supervisor Name: _____________________________________________________________ Supervisors Name

Employer Address: ____________________________________________________________ Business Address

Employer Email Address: _______________________________________________________ Employer Email Address

Do you want TVCC to release your academic information to your employer, spouse, or other

third party? Or can the CBWCL staff talk with your employer about your education?

☐ YES ☐ NO

If you answered yes, please provide us with a completed Student Release of Information Form.

If you have any questions, please contact the CBWCL office at (541) 881 - 5755

or email cbwcl@tvcc.cc

www.tvcc.cc · 650 College Boulevard, Ontario, OR 97914 · (541) 881- 8822 · (541) 881- 2723 (TTY) Treasure Valley Community College does not discriminate on the basis of race, color, sex, marital status, sexual orientation, religion, national origin, age or disability in any educational programs, activities or employment. Persons having questions about equal opportunity and nondiscrimination should contact the Human Resources Director located in the Student Services Center on the south side of the

Four Rivers Cultural Center building, email HR@tvcc.cc or call (541) 881-5838 or TTY (541) 881-2723. Form Update: 9.14.16

STUDENT RELEASE OF INFORMATION

Registrar

Student Name: Student ID#:

In compliance with the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA), it is the policy of Treasure Valley Community College (TVCC) not to release information other than directory information about enrolled students without written permission of the student.

I authorize the release of the following information or material pertinent to my attendance at TVCC:

� Business Office information: Including but not limited to billing statements, charges, credits, payments, past dueamounts, and/or collection activity.

� Registrar Office information: Including but not limited to GPA, demographic, course registration, student ID, academicprogress and/or enrollment information.

� Financial Aid Office information: Including but not limited to awards, application data, disbursements, eligibility and/orfinancial aid satisfactory academic progress.

� Athletic Department information: Including but not limited to medical records/history, injury status, protected healthinformation, and/or health care providers. In addition, any information requested from any other college or university asit relates to participation, attendance, seasons of eligibility, red shirt, hardship, and suspensions.

I authorize the release of the items selected above to the following individual(s) and/or organization (s):

Name Organization Relationship Address

Additional Comments:

I understand that this will allow Treasure Valley Community College to interact with agencies and other parties as it pertains to my education. This release is valid until I notify the TVCC Student Services Center, Financial Aid, Business Office, Registrar’s Office, or Athletic Office, in writing, to cancel it.

� I agree that photocopies of this authorization may be used by TVCC as necessary.

� I give TVCC my expressed permission to publicize any photographs of me on the TVCC website.

___________________________________ Student name (printed) ___________________________________Student Signature ___________________________________ Date

___________________________________ Parent name (printed) ___________________________________Parent Signature ___________________________________ Date

1 TVCC IS AN EQUAL OPPORTUNITY EDUCATOR AND EMPLOYER

.

Agile Homes Trades Scholarship Application

Purpose: The purpose of the Agile Homes Scholarship is to encourage local young adults to join the electrical and plumbing trades and to utilize Treasure Valley Community College’s certified Apprenticeship programs for their educational requirements. Agile Homes wants to ensure that our communities have a strong, skilled trade workforce. By investing in our youth and young adults, Agile Homes will be a part of building our next generation of skilled trades professionals. Emphasis will be placed on entry level apprentices (Years 1 & 2), to help jumpstart them into this professional career opportunity.

Areas of Interest: Trades related fields or professions including Electrical and Plumbing apprentices. (Note: Currently TVCC doesnot have an HVAC apprentice program. We are working toward that.)

Award Categories/Level of Education: $500 per student maximum annual scholarship with the option of an additional $500 award if the student apprentices under Shilo Plumbing, Powerhouse Electric or L&H Heating and Cooling for electrical or plumbing. Total award to each student will not be more than $1,000.00 per school year.

Eligibility Requirements:

Registered as First (1) or Second (2) Year Apprentice at Treasure Valley Community College’scertified Electrical Apprentice or Plumbing Apprentice program.

Based on financial need. Priority given to students with financial need and have a relationship with the Boys and Girls Club

of Ontario, OR or Payette, ID. Priority given to students with financial need Priority given to students who are apprenticing with Shilo Plumbing, Powerhouse Electric and/or

L&H Heating and Cooling.

Payment: Students will pay course fees in full upon registration. Scholarship payment will be applied to student account when funds are released by the TVCC Foundation. Students that do not have an account balance will receive a check from the business office at the end of October 2021.

Application Deadline: August 16 2021

Mail or drop off completed application to: Attn: Center for Business, Workforce & Community Learning at Treasure Valley Community College Agile Homes Scholarship 650 College Blvd., Ontario, OR 97914

For questions or additional information:

Email cbwcl@tvcc.cc or call Andrea (541) 881-5761 or Jimsie (541) 881-5755.

2 TVCC IS AN EQUAL OPPORTUNITY EDUCATOR AND EMPLOYER

____________________________ __________________________ _________________________ Social Security Number Date of Birth TVCC ID (if known) (required to disburse funds)

___________________________________________________________________ First Name Last Name Middle Initial

_________________________________________________________________________ Mailing Address City and State Zip Code

___________________________________________________________________ County Home Phone (with area Code) Cell Phone (with area Code)

_________________________________________________________________________ Email Address (Most communication will be through email)

Last High School/GED Attended _______________________________________ Graduated? ☐ Yes ☐ No School Year

Previous College Attended ____________________________________________ Graduated? ☐ Yes ☐ No School Year Area of study

Intended area of study: ☐ Electrical Apprenticeship ☐ Plumbing Apprenticeship

Do you have a valid Apprentice Card? ☐ Yes ☐ No State: ☐ Idaho ☐ Oregon ☐ Both

What level of apprentice? ☐ 1 ☐ 2

_______________________________________________________________________________________ Employer (To verify employment) Contact Name Phone Number *Note: Please contact the CBWCL office if you do not have an apprentice number or an employer.

Do you have a relationship with the Boys and Girls Club of Ontario, OR or Payette, ID? ☐ Yes ☐ No

ESSAY Questions: (Minimum of 2 paragraphs each)

1. Please describe why you are choosing to pursue a career in the electrical or plumbing trades? 2. Tell us about yourself. Include your current life situation, career goals, community involvement, and list of

local clubs or organizations that you participate in. 3. How do you plan to finance your education? Describe how this scholarship will help you financially.

Academic Records: Include a COPY of your most recent TRANSCRIPTS or GED Test Scores. You do not need “Official Transcripts”. If you are an Electrical Apprentice, you may need to provide proof of having completed one full year of high school algebra or integrated math 2, with a passing grade of 'C' or better or one post high school algebra course (equivalent to one-year high school algebra with a passing grade of 'C' or better) or have community college placement test results showing equivalent.

Application Deadline August 16 2021 I certify that all information I have provided in this application is true and complete to the best of my knowledge. I authorize the release of information on this application and other necessary academic information to the TVCC Foundation, individual donors, and selection committees. _______________________________________________________________________________________________________________________________________________________________________________________________

Signature Required Date

Applications that are not complete, do not include essays or transcripts will not be accepted.

Each application is evaluated and given scores on the following criteria:

Overall presentation of the application Financial Need Educational or Career Goals

If you are a US Citizen, your social security number is required to disburse funds through the Financial Aid office. Your social security number will not be given to the general public. If you choose not to provide your social security number, you will not be denied any rights as a student. Please read the statement in the Schedule of Classes which describes how your number will be used. Providing your social security number means that you consent to use of the number in the manner described.

TVCC IS AN EQUAL OPPORTUNITY EDUCATOR AND EMPLOYER

General Journeyman (Inside) Electrician 4 year program - 576 Hours

Manufacturing Plant Electrician 4 year program - 576 Hours

Curriculum is certified for both Idaho and Oregon registered apprentices

If you are you looking to get your electrical

apprenticeship courses completed in a fun

personalized learning environment with small

class sizes - TVCC is here to exceed your

expectations.

Students now have the availability to attend

class via Zoom if they are working out of town.

We have also implemented the Mike Holt

Capacitor program into the curriculum to allow

students to access their textbooks, homework,

and videos online.

For Information Contact:

Jimsie Crouch (541) 881-5755 cbwcl@tvcc.cc

The General Journeyman Electrician (Inside) and Manufacturing Plant

Electrician Apprenticeships are overseen by the

Classes Begin

August 23 (1st

YR) & 24 (2nd YR),

2021

Registration

Deadline:

August 9, 2021

Course Fee $950.00

*Textbook fees additional.

(Approx. cost of $400.00)*

Location:

Treasure Valley

Community College

CTE Center

Room #101

Instructors: Justin Blazzard John Howard David Beals

Treasure Valley Community College is an equal opportunity educator and employer. Reasonable accommodations for persons with disabilities will be made if requested at least two weeks in advance.

Agile Homes has created a scholarship opportunity for TVCC Electrical and

Plumbing Apprentices

General Journeyman (Inside) Electrician Manufacturing Plant Electrician

For More Information Contact:

TVCC CBWCL

(541) 881-5755 | cbwcl@tvcc.cc

YEAR 1: Introduces apprentices to the principles associated with electricity, electrical theory, and the basics of electrical systems. These basic fundamentals are necessary to understand the complex NEC requirements covered throughout the curriculum. Digital multimeter principles will also be addressed. In the latter part of this level students will be introduced to, and begin utilizing,

YEAR 2: Focuses on the first few chapters of the National Electrical Code. Some equipment specific to alternating current will be introduced. Residential and commercial wiring methods and practices will also be covered in depth in this level. Students will develop a further knowledge of construction safety, electrical safety, and the NEC. As they study rules in the Code, they’ll develop a greater understanding of the purpose of the NEC’s general wiring methods, materials, and different types of protection along with gaining a deeper understanding of residential and commercial wiring systems.

YEAR 3: In this level, students will continue building their foundation of knowledge about construction safety, electrical safety, and the National Electrical Code. Additional OSHA construction safety rules and chapters of the NEC are covered, then centers on common industrial applications, methods, and requirements. While motors and controls are the major focus area, hazardous locations, special applications, solar photovoltaic systems, and power quality are also introduced.

YEAR 4: This final level of the program covers advanced Code calculations in great detail. Electrical estimating is discussed in the first part of the level as well as a review of electrical theory and motor controls. Additional OSHA construction safety rules, basic business management, and interpersonal skills will also be covered as well. Students will develop a further knowledge of construction safety, electrical safety, and the NEC in preparation for their journeyman exam. They’ll also gain an understanding of basic leadership principals necessary to excel on the job and be introduced to some fire alarm system basics.

Oregon Minimum Qualifications To qualify for registration as an Electrical Apprentice, an applicant must:

Be employed by a member of a Training Committee (or become a member).

Be 18 years of age. Applicant shall be a high school graduate or have a GED Certificate of Equivalency. Must have completed one full year of high school algebra

with a passing grade of 'C' or better or one post high school algebra course

https://www.oregon.gov/boli/apprenticeship

Idaho Minimum Qualifications To qualify for registration as an Electrical Apprentice, an applicant must:

Be at least 16 years of age. Submit a completed notarized application (included). Pay the $15 (non-refundable) license registration fee.

dbs.idaho.gov

4 years 8,000 on-the-job hours 576 classroom hours