TRUCK AND TRANSPORT MECHANIC STATUTORY DECLARATION OF WORK EXPERIENCE

Transcription

1 T qualify t challenge certificatin in this trade r be granted authrity t supervise and sign-ff n apprentices in this trade, individuals must have: wrked a minimum f 9,000 hurs perfrming the tasks listed in Sectin E, and experience perfrming at least 70% f the jb tasks listed in Sectin E Hlders f a Certificate f Qualificatin (CfQ) in Heavy Duty Equipment Technician will be eligible t challenge this certificatin r receive Supervisin and Sign-Off Authrity by dcumenting nly 4,500 wrk-based hurs f directly related wrk experience. Hlders f a Certificate f Qualificatin (CfQ) in Transprt Trailer Technician r Diesel Engine Mechanic will be eligible t challenge this certificatin r receive Supervisin and Sign-Off Authrity by dcumenting nly 7,500 wrk-based hurs f directly related wrk experience. Hlders f a military certificate in Vehicle Technician MT #129 / MT #411, QL5 r higher will be eligible t challenge the Truck and Transprt Mechanic Inter-Prvincial Red Seal examinatin. A Statutry Declaratin f Wrk Experience is used t declare wrk experience fr perids during which yu were self-emplyed r a previus emplyer is unavailable t cmplete an Emplyer Declaratin. Please nte that unless yur wrk experience hurs were gained thrugh self-emplyment, Certificatin Challenge and Supervisin and Sign-Off Authrity applicatins will nt be accepted if they are nly accmpanied by a Statutry Declaratin. Nn-self-emplyed applicants must prvide an Emplyer Declaratin frm at least ne emplyer wh can verify wrk experience. Fr mre infrmatin, see Instructins fr Certificatin Challenge r Supervisin and Sign-ff Authrity. The infrmatin prvided n this frm is used t assess and t validate yur wrk experience in this trade. A. Applicant Name B. Supervisr r Self-Emplyment Cntact Infrmatin Enter the cntact infrmatin fr the Supervisr at yur previus emplyer wh is unavailable t cmplete an Emplyer Declaratin, r fr yur wn business if yu are self-emplyed. Name f Organizatin/Emplyer/Business: Supervisr Name: Supervisr s Psitin/Title: Suite Number: Street Number and Name: City: Prvince: Pstal Cde: Telephne Number: ( ) Business Registratin Number: (Self-Emplyment nly) Page 1 f 5 The Industry Training Authrity is an agency f the Gvernment f British Clumbia. April 2016

2 C. Emplyment r Self-Emplyment Infrmatin f Applicant Enter the dates and number f hurs fr this perid f emplyment r self-emplyment. Cmbine multiple perids f self-emplyment n ne frm, but separate perids f emplyment with different emplyers n separate frms. Dates f Emplyment (MM/DD/YYYY): Frm: T: Ttal Number Hurs f Truck and Transprt Mechanic (Cmmercial Transprt Vehicle Mechanic) Experience Accumulated in that Perid: Jb Title f Applicant: D. Reasn fr Statutry Declaratin Indicate why a Statutry Declaratin is required fr this perid f emplyment: Applicant was self-emplyed Emplyer is n lnger in business Emplyer will nt cmplete Emplyer Declaratin Emplyment recrds are nt available Applicants must attempt t cntact current r previus emplyers t request an Emplyer Declaratin. If yu have been unable t btain an Emplyer Declaratin fr any prtin f yur nn-self-emplyed wrk experience, indicate the steps yu have taken t try t btain it. If sufficient evidence f steps taken is nt prvided, the applicatin may nt be apprved. Page 2 f 5 The Industry Training Authrity is an agency f the Gvernment f British Clumbia. April 2016

3 E. Statutry Declaratin f Jb Task Perfrmance By checking Yes r N in the Declaratin Respnse clumn, indicate whether r nt yu have perfrmed the jb tasks listed belw. Crss ut any jb tasks yu did nt perfrm during the perid indicated in Sectin C. Jb Tasks Occupatinal Skills Includes: Cmpleting maintenance recrds and dcuments; perating and maintaining tls and equipment; inspecting and cleaning vehicle cmpnents; cnducting rad tests; and maintaining vehicle. Chassis and Frames Includes: Mdifying length and height f frames; and wrking n suspensins, hitches, and cuplers. Air Systems, Brakes, and Steering Includes: Wrking n air systems, braking systems, steering systems, and tires, wheels, rims and hubs. Electrical and Electrnic Systems Includes: Wrking n electrical systems; charging systems; starting systems; ignitin systems; electrical cnductrs and cnnectrs; electrnic cmpnents, and electrical and electrnic accessries. Cab and Bdy Includes: Wrking n heating, ventilatin, air cnditining and refrigeratin systems; trailer bdies; and cab bdy and trim. Engine and Supprting Systems Includes: Wrking n engines; cling systems; lubricatin systems; fuel systems; intake, exhaust and emissin systems; and auxiliary braking systems. Drive Train Includes: Wrking n clutches; standard transmissins; autmatic transmissins; drive lines; and differentials and transfer cases. Accessries Includes: Wrking n accessries and hydraulic systems. Declaratin Respnse Page 3 f 5 The Industry Training Authrity is an agency f the Gvernment f British Clumbia. April 2016

4 F. Cnfirmatin f Prerequisite Credentials r Certificates Fr sme trades, evidence that the applicant has earned prerequisite credentials r certificates is required befre the individual is permitted t challenge certificatin r receive Supervisin and Sign-Off Authrity. Fr thse trades, yu must prve yu have the required prerequisite credentials. There are n prerequisite credentials r certificates fr this trade. G. Applicant Signature I certify that the infrmatin I have prvided is accurate. (Nte: Cllectin and prtectin f persnal infrmatin n this frm is in accrdance with the prvisins f the Freedm f Infrmatin and Prtectin f Privacy Act.) Applicant Name (please print): Applicant Signature: Date: (MM/DD/YYYY) Page 4 f 5 The Industry Training Authrity is an agency f the Gvernment f British Clumbia. April 2016

5 H. References References must accmpany all Statutry Declaratins. Include with yur cmpleted Statutry Declaratin the names and cntact infrmatin f three individuals wh can verify yur self-declared wrk experience in this trade. This may include suppliers (maximum ne), frmer emplyees (maximum ne), cntractrs, r regular, lng-term clients (maximum ne). Each individual listed will be cntacted by ITA t verify the infrmatin prvided n yur applicatin. 1. Reference Psitin/Title: 2. Reference Psitin/Title: 3. Reference Psitin/Title: Page 5 f 5 The Industry Training Authrity is an agency f the Gvernment f British Clumbia. April 2016