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Please complete the questions over the next couple screens to enroll in the apprenticeship program and enable the South Bay Workforce Investment Board to support your training. Enrollment in the apprenticeship is completely voluntary and complete and it will take less than 10 minutes to complete this application. The information you share will be stored securely and will not impact your employment in any way.

Participant Information

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Valid social security number is required
or check box below if you do not have one
.
xxx
Valid date of birth is required.
Your first name is required.
Your last name is required.
Please enter a valid phone number.
Please provide a valid phone type.
Please enter a valid phone number.
Please provide a valid phone type.
Please enter a valid email address.
Your home address is required.
Please select a valid city.
Please provide a valid state.
Zip code required.
Your home county is required.

Emergency Contact

Emergency contact first name is required.
Emergency contact last name is required.
Relationship of emergency contact to you is required.
Please enter a valid emergency contact phone number.
Please enter a valid email address.
Emergency contact address is required.
Please select a valid city.
Please provide a valid state.
Zip code required.

Demographics

Please indicate your sex or if you decline to answer.
Please indicate your preferred pronouns.

Click for definition
Please select at least one option below.
Please select at least one option
Please indicate if you are of Haitian heritabe.
Please select what you are.
Please choose a date or enter "N/A" if not applicable.
Please enter a valid number.
Must provide only one of the following
Please enter a valid number.
OR
Please enter a valid number.
OR
Please enter a valid passport number.
Please choose the passport country of issuance.
Please indicate if you are a veteran or decline to answer.
For info on requesting your DD-214 form: Request your military service records

Supported formats are pdf and word document.

Form DD-214 must be uploaded if a veteran.
Please indicate if you are a spouse of a veteran.
Please indicate if you are registered for the Selective Service System.
(other than reserve status)
Please indicate if you have served on active duty.
Invalid Month.
/
Invalid Year.
Invalid Month.
/
Invalid Year.
Invalid Total.
Please indicate if you are disabled or decline to answer.
Please indicate if you need accommodation for work.
Mark Yes if you have a limited ability in speaking, reading, writing or understanding the English language and (a) your language is a language other than English, and/or (b) you live in a family or community environment where a language other than English is the dominant language.
Please indicate if you are learning English as a non-native speaker.
Mark Yes if you have been arrested/convicted of a crime.
Please indicate if you are an ex-offender.
Mark Yes if you self-identify with at least one of the following:
  1. meet ALL of the following:
    • have been terminated or laid off, or have received a notice of termination or layoff, from employment
    • are eligible for or have exhausted entitlement to unemployment compensation
    • are unlikely to return to a previous industry or occupation
  2. meet ALL of the following:
    • have been terminated or laid off, or have received a notice of termination or layoff from employment as a result of any permanent closure of, or any substantial layoff at, a plant, facility, or enterprise
    • are employed at a facility at which the employer has made a general announcement that such facility will close
  3. were self-employed (including employment as a farmer, a rancher, or a fisherman) but are unemployed as a result of general economic conditions in the community in which you reside or because of natural disasters
  4. are a displaced homemaker (an adult who has lost their primary source of income and no longer has proper financial support)
  5. are the spouse of a member of the Armed Forces on active duty
Please indicate if you are a dislocated worker.
Please indicate if the COVID-19 pandemic is why you became a dislocated worker.
Please provide an explanation.
Mark Yes if you are an adult who has lost their primary source of income and no longer has proper financial support.
Please indicate if you are a dislocated worker.
Please indicate if you experienced unemployment due to the COVID-19 pandemic.
Please provide an explanation.
Please enter the number of family members residing with you.
Please select the number of dependents.
Please indicate if you are claimed as a dependent from anyone on their tax forms.
Please indicate the relationship of the claimant to you.
Please indicate if you or an immediate family member living with you are receiving public assistance.
Mark All received by you or an immediate family member living with you.
Please select at least one public assistance option or answer no to receiving public assistance.
Describe the other public assistance received.
Please describe other public assistance.
Please indicate if you are near exhausting CalWORKS (TANF).
Please indicate if you are a current or former foster youth.
Please indicate if you are currently or formerly unhoused.
(Parent includes being a pregnant woman)
Please indicate if you are a single parent.
Please indicate if you have an incarcerated parent.
Mark All that apply.
Please select at least one concern.
Please describe other concern getting to work.

Education & Training

Please select your highest education level completed.
Please select your highest degree received.
Please indicate what your degree is in.
Please describe your certificate(s) received.
Please indicate if you are enrolled in school/another educational program.
School/Program Name is required.
Please enter a valid city.
Please provide a valid state.
Please select full or part-time.
Please indicate if you are receiving financial aid for school.
Please select the highest grade/year you have completed.
Please selection completion month.
Please enter completion year (YYYY).
Please select your anticipated degree/credential.
Please describe your anticipated credential.
Examples include resume building, interviewing, time management, written/verbal communication, problem solving, leadership, teamwork, other soft skills
Please indicate if you have taken any work readiness skills training.
Please describe the skills training you have taken.
Please indicate if you have completed a pre-apprenticeship program.
Program Name is required.
Your home address is required.
Please select a valid city.
Please provide a valid state.
Zip code required.
Please indicate if you have any documents related to this occupation.

Please upload the following:

  1. Certificates
  2. Transcripts
  3. Proof of any degrees, credentials, or relevant certifications
Please provide a description.
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Uploaded Documents
File Name Description
No uploaded documents
Please indicate if you are receiving or have been notified you will receive a Pell Grant.

Career Pathway Information

Career interests are required.
Why you want to participate is required.
Short-term goals are required.
Long-term goals are required.

Additional Information

Please select at least one way you learned of this program.
Please describe how you learned about this program.

Supported formats are pdf and word document.

Resume must be uploaded if Yes is selected.
Please indicate if you have a LinkedIn public profile.
Find Your LinkedIn Public Profile URL
Please enter your LinkedIn profile URL.

Employment Information

Please indicate if you are currently employed.
Please select your unemployment status.
Please indicate if you are having difficulty finding work.
Please indicate your employment status.
Click for explanations
Please select your career connection.
Please indicate your status prior to hire.
Employer is required.
Employer name is required.
(if known)
Please enter a valid hire date.
Please select a valid city.
Please provide a valid state.
Zip code required.
Please enter a valid employer phone number.
Please enter your employer's email.
Please describe the position at your employment.
Please enter a valid number of hours per week.
Please enter your hourly wage.
Please select the number of years you have been employed full time.

Identity & Employment Authorization Documents

Please upload your identity documents by clicking here or on the green upload button below. You may choose one item from list A OR one item each from list B AND C. If you need help with this or have questions please give us a call at (310) 970-7700, ask for Marketing.

Please upload your identity document by clicking here or on the green upload button below. You may choose one item from list A OR one item from list B. If you need help with this or have questions please give us a call at (310) 970-7700, ask for Marketing.

Please upload a document that establishes your identity (List A or List B).
Please upload a document that establishes your employment authorization (List A or List C).
OR
AND

Paid Work Experience

The following information will allow for direct deposit of your pay and determine the proper withholding for tax purposes.

Direct Deposit

Please enter your bank information below to enroll in direct deposit so your paychecks will automatically be deposited into your bank account (instead of them being mailed).
Please indicate if you have a bank account.
Financial institution is required.
Routing number is required.
Account number is required.
Please indicate the type of account.
Please check the box to grant direct deposit authorization.
Please upload a copy of a voided check (a check from your bank account above with the words “void” on it) OR the first page of a bank statement from the bank account above that shows your name and bank account number.
Deposit document must be uploaded if Yes is selected.

Withholding (W-4)

Please enter the information below so the SBWIB can withhold the correct federal income tax from your pay.
Step 1: Personal Information
(Choose only if you're unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)
Please choose a filing status.
Complete Steps 2 through 4 ONLY if they apply to you. Otherwise, click Next below. For more information on each step, see page 2 of the W-4 form.
Step 2: Multiple Jobs or Spouse Works (Optional)

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all of these jobs.

Do only one of the following:

b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below.
OR
c) If there are only two jobs total, you may check this box:   
Do the same on Form W-4 for the other job. This option is generally more accurate than (b) if pay at the lower paying job is more than half of the pay at the higher paying job. Otherwise, (b) is more accurate.
Please check the box if there are only two jobs.
Step 3: Claim Dependent and Other Credits (Optional)

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

$
Please enter a valid amount (multiple of 2000).
$
Please enter a valid amount (multiple of 500).
$
Please enter the claimed dependents and other credits total.
Step 4: Other Adjustments (Optional)
$
Please enter the other income amount.
$
Please enter the deductions amount.
$
Please enter the extra withholding amount.

Review and Sign

For Review and Signature

Please open and review each of the documents in the table below. If any of the information is incorrect, please go back and make the appropriate changes.

Document
Preparing Documents...
For Review Only

The following documents are for review only.

Note: Word documents have to be downloaded to view

Document
Media Release
Please indicate if you do or do not grant permission.

I grant permission to the South Bay Workforce Investment Board (SBWIB) and the South Bay One Stop Business & Career Center, its employees or representatives, to take and use printed or electronic publications of my name, story, quotes and images (all formats) including photographs/digital images, videos, audio recordings, quoted remarks, written material, educational materials, PowerPoint presentations, other electronic, written or hard copy forms of communication and any other form of communication for the purpose of publishing or republishing my success story and images, this includes publicizing the material in newspapers, on websites, through social media, at meetings and public events or at any other venue the SBWIB and One Stop Business & Career Centers may participate.

I hereby acknowledge that my participation is voluntary and I will not receive any form of compensation and agree that all content as described above will remain the property of the SBWIB free from any claims by me or anyone acting on my behalf.

I hereby release the SBWIB and its representatives from any and all claims and demands that may arise out of or in connection with the use of the materials listed above. This release shall be binding on upon me and my heirs, legal representatives and assigns. Should I desire to rescind this permission I will do so with 10 days written notice to the address below.

Your Signature

Sign by typing your name below and entering today's date. Your signature certifies the following:

  • All information I provided is true and correct and that I understand, agree to, and am signing all the relevant attachments above.
  • I provide permission to share and use my personal identifiable information as needed to manage my apprenticeship training program and to retrieve the information from my employer as necessary. I also understand that I may be contacted directly by program personnel for additional information if needed or to verify training progress.
  • I acknowledge that this apprenticeship opportunity is voluntary and I am choosing to enroll in the apprenticeship to further to my education and enhance my skills.
  • All information I provided is true and correct and that I understand, agree to, and am signing all the relevant attachments above.
  • I provide permission to share and use my personal identifiable information as needed to manage my pre-apprenticeship training program and to retrieve the information from my employer (if applicable) as necessary. I also understand that I may be contacted directly by program personnel for additional information if needed or to verify training progress.
  • I acknowledge that this pre-apprenticeship opportunity is voluntary and I am choosing to enroll in the apprenticeship to further to my education and enhance my skills.
Your signature is required.
Click for today's date
Valid date is required.
Your Parent/Guardian

Please have your parent/guardian review, complete, and sign the following section.

Media Release
Please indicate if you do or do not grant permission.

I grant permission to the South Bay Workforce Investment Board (SBWIB) and the South Bay One Stop Business & Career Center, its employees or representatives, to take and use printed or electronic publications of my child's name, story, quotes, and images (all formats) including photographs/digital images, videos, audio recordings, quoted remarks, written material, educational materials, PowerPoint presentations, other electronic, written or hard copy forms of communication and any other form of communication for the purpose of publishing or republishing my success story and images, this includes publicizing the material in newspapers, on websites, through social media, at meetings and public events or at any other venue the SBWIB and One Stop Business & Career Centers may participate.

I hereby acknowledge that my participation is voluntary and I will not receive any form of compensation and agree that all content as described above will remain the property of the SBWIB free from any claims by me or anyone acting on my behalf.

I warrant and represent that I am the parent/guardian of the minor listed above. I hereby release the SBWIB and its representatives from any and all claims and demands that may arise out of or in connection with the use of the materials listed above. This release shall be binding on upon me and my heirs, legal representatives and assigns. Should I desire to rescind this permission I will do so with 10 days written notice to the address below.

Your parent/guardian's name is required.
Please enter a valid email address.
Please enter a valid phone number.
Your Parent/Guardian Signature

Have your parent/guardian sign by typing their full name below and entering today's date. Their signature certifies that all information provided is true and correct and that they understand, agree to, and are signing all the relevant attachments above.

Your parent/guardian's signature is required.
Click for today's date
Valid date is required.

Application Complete

Thank you for completing your enrollment application!

We will be in touch shortly for further actions.