First Name *Last Name *Previous Apprentice Coursework Completed *NoneYear 1Year 2Year 3OtherPlease indicate the highest completed level of previous apprentice classroom trainingEmail *Mobile Phone# *Just numbers- no dashes or spaces0 / 10Street Address *Home addressApartment, suite, etcCity *State/Province *ZIP / Postal Code *Contractor/Employer *Business NameBusiness AddressEmployer/contactor addressSuite/UnitCityState/ProvinceZIP / Postal CodeSupervisor/Contact Name *Supervisor/Contact Email AddressSupervisor/Contact Phone#Area code and phone number, no dashes0 / 10Supervisor/Contact ExtensionEnter Extension, if needed0 / 10Electricians License(s) Number(s)Enter all license numbers if multiple states, separated by commasLicense State(s)If multiple states, enter in order of license numbers with comma betweenConsent *IEC Dakotas offers Years 1-4 electricians apprentice classroom training, starting the fall of each year, either online or in one of our classrooms in Sioux Falls, Fargo, Grand Forks, and Rapid City. I understand that my employer may or may not pay for this classwork. If submitted before open enrollment (beginning July 1, 2024) this form is simply to indicate additional information on the program is requested.Register
