The Georgia Funeral Service Apprenticeship form is a crucial document for individuals seeking to register as Funeral Service Apprentices in the state of Georgia. This form outlines the necessary steps and requirements for initial registration, as well as any changes in location or supervisor. Completing this form accurately is essential to ensure a smooth approval process and to embark on a meaningful career in funeral service.
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The Georgia Funeral Service Apprenticeship form is an essential document for anyone looking to embark on a career in funeral service within the state. This application serves multiple purposes, including initial registration as a Funeral Service Apprentice and requests for changes in location or supervision. Applicants must meet specific requirements, such as being at least 18 years old, providing proof of education, and submitting the necessary fees. The form outlines the apprenticeship details, including a minimum duration of 18 months and a total of 3,120 hours of service, which must be completed under the supervision of a licensed embalmer and funeral director at a Board-approved establishment. It is crucial for applicants to review their submissions thoroughly, as incomplete forms can lead to delays in approval. Additionally, any changes to the apprenticeship site or supervisor require a new application, emphasizing the importance of maintaining accurate records throughout the apprenticeship period. Understanding these key aspects will help ensure a smooth application process and set the foundation for a successful career in funeral service.
GEORGIA STATE BOARD OF FUNERAL SERVICE
237 COLISEUM DRIVE
MACON, GA 31217
478.207.1460
FAX 478.207.1468
www.sos.state.ga.us/plb/funeral
FUNERAL SERVICE APPRENTICESHIP
INSTRUCTIONS FOR APPLICANTS
FOR INITIAL REGISTRATION OR ANY CHANGE IN LOCATION OR SUPERVISOR
RULE 250-4
Before filing an application for registration as a Funeral Service Apprentice,
please read Board Rule, Chapter 250-4, which details specifically the
requirements for apprenticeship. The rule may be reviewed on our website.
REQUIREMENTS
·
FEE
Refer to fee listing on the application. Application fees are non-refundable.
Make payment by check or money order to Georgia State Board of Funeral
Service.
AGE
You must be 18 years of age on the date that the Board receives your application.
·EDUCATION You must attach a copy of your high school diploma or GED Certificate to this application.
APPRENTICESHIP DETAILS
DATE OF
The date your apprenticeship begins will be determined by the date your
REGISTRATION:
application is approved by the Board. The Board will approve your
application only when it is completed. It is imperative that you the
applicant review your application prior to submitting it to the Board office,
as incomplete applications will result in unnecessary delays in the approval
of the applications.
HOURS:
3120 hours(the equivalent of 18 months of full-time service).
DURATION:
A minimum of 18 months. The apprenticeship registration, which is valid
for two years, may be renewed twice. The apprenticeship time is in
addition to the time required to graduate from a college of funeral service or
other college.
SUPERVISION:
An apprentice must serve at a Board-approved establishment and under a
Board-approved embalmer and funeral director.
REPORTS:
An apprentice must complete report forms which may be obtained from the
Board office or on the Board website. It is the responsibility of the
apprentice to maintain records of service.
CHANGES:
An apprenticeship is approved for a specific establishment and under a
specific supervising embalmer, funeral director, or both. Any change shall
terminate the apprenticeship immediately. You must then submit a new
application, which must be presented to the Board for approval. Reports
must be kept current and must be available for review by the Board
inspector.
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237COLISEUM DRIVE MACON, GA 31217
478.207.1460 FAX 478.207.1468
DO NOT WRITE IN THIS SECTION
RECEIPT # _____________________
AMOUNT ______________________
APPLICANT # __________________
INITIAL _____ DATE ___________
APPLICATION FOR FUNERAL SERVICE APPRENTICESHIP
REASON FOR APPLICATION:
Make checks payable to: The GA Board of Funeral Service
(
)
Initial Funeral Service Apprenticeship
$
40.00
Non Refundable
Change in Apprenticeship Site(to include change of supervisors)
20.00
Change in Supervising Embalmer&/Or Funeral Director Only
20.00 Non Refundable
Reinstatement of Apprenticeship Registration # ___________
$180.00
Instructions:
-Apprentice Applicant must complete Part I and Part V
-Supervising Embalmer must complete Part II
-Supervising Funeral Director must complete Part III
-Funeral Director in Full & Continuous Charge, on behalf of the Funeral Establishment, must complete Part IV
PART I – APPRENTICE APPLICANT (Please print or type)
FIRSTMIDDLELAST
*FOR CHANGE OF SITE OR SUPERVISOR ONLY, LIST APPRENTICESHIP REGISTRATION #_________
CURRENT RESIDENCE ADDRESS
___________________________________________________________________________________________________________
STREET(INCLUDE APT/LOT #)
CITY
COUNTY STATE ZIP CODE TELEPHONE NUMBER
SOCIAL SECURITY NO.*: ______-____-_________
*THIS INFORMATION IS AUTHORIZED TO BE OBTAINED & DISCLOSED TO STATE & FEDERAL AGENCIES PURSUANT TO O.C.G.A. § 19-11-1 & O.C.G.A. § 20-3-295, 42 U.S.C.A. § 551 & 20 U.S.C.A. § 101.
U.S. CITIZEN : _____ YES _____ NO*
*LIST CITIZENSHIP:_______________________________________
& SUBMIT A COPY OF REGISTRATION CARD
PLACE OF BIRTH:
______________________________________________
CITYSTATE OR COUNTRY
AGE: ________
DATE OF BIRTH : _______/_________/_____________
GENDER
: _____ MALE _____ FEMALE
__________
HEIGHT
WEIGHT
EYES
HAIR
APPRENTICESHIP SITE INFORMATION
________________________________________________________________________
________________________________
FUNERAL ESTABLISHMENT NAME
LICENSE NUMBER
SUPERVISING DIRECTOR
SUPERVISING EMBALMER
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PART I – APPRENTICE APPLICANT (CONTINUED)
The Apprentice Applicant must answer the following questions. If your answer is “Yes” to any of the following questions, please explain, giving current status and attach additional sheets and documentation, if necessary.
Yes
No
Are you currently registered as an Apprentice?
If “Yes,” please provide your Apprentice Registration Number:________________
Have you ever been registered you as an Apprentice in this state?
Are you a high school graduate, or have you obtained a GED Certificate?
You must attach a copy of your diploma or GED certificate to this application.
Do you now hold, or have you in the past held, a professional license in any state?
If “Yes”, submit an original notarized letter from the state of licensure.
Have you had revoked or suspended or otherwise sanctioned any license issued to you
by any board or agency in Georgia or any other state?
Were you denied issuance of or, pursuant to any disciplinary proceedings, refused
renewal of a license by any board or agency in Georgia or any other state?
Have you knowingly failed to renew a license during an investigation or disciplinary
action?
Have you been subject to disciplinary action or had your membership revoked by a
professional organization governing the practice of that profession?
To the best of your knowledge, is there any disciplinary action pending against you by
any licensing board or professional organization?
Have your been arrested, charged or sentenced for the commission of a felony or any
crime involving moral turpitude?
Are you unable to practice with reasonable skill and safety due to illness or use of
alcohol, drugs, narcotics, chemicals or any other types of material, or as a result of any
mental or physical condition?
Have you had any suit filed against you related to the practice of a profession?
Have you ever been convicted of a felony or misdemeanor (other than a minor traffic
violation), entered a plea of guilty or nolo contendere, entered a plea under first
offender provision? If “Yes”, attach a certified copy of the judgment rendered.
AFFIDAVIT
I Hereby swear or affirm that the answers and information contained in this section of the application are true, complete, and correct. I understand that making a false or misleading statement on this form is a crime and may result in criminal prosecution and in my being denied a registration from the Georgia State Board of Funeral Service.
STATE OF GEORGIA
COUNTY OF ___________________________________
SIGNATURE OF THE APPLICANT
SUBSCRIBED AND SWORN TO BEFORE ME THIS
________ DAY OF _____________________, _________
PRINT NAME
_______________________________________________
NOTARY PUBLIC
DATE
MY COMMISSION EXPIRES: _____________________
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PART II – SUPERVISING EMBALMER
INSTRUCTIONS:
-Supervising Embalmers must have been employed as a licensed embalmer at least 3 years prior to the supervision.
-One supervisor may not supervise more than 4 apprentices.
-Supervising Embalmers must provide direct supervision, which shall mean a licensed supervisor present in the same room as apprentice during the embalming of a body.
-Trade Embalmers – Must appear before the Board and must embalm at the establishment where
the Apprentice is registered.
( ) Yes ( ) No Are you a Trade Embalmer?
When did you become licensed as an Embalmer?________________________________________________
OTHER APPRENTICES CURRENTLY SUPERVISING
NAME
REGISTRATION NUMBER
I, the undersigned, do hereby swear or affirm under penalty of perjury that all statements made and information contained in this application are true and correct to the best of my knowledge and belief. I understand that any willful omission or falsification of pertinent information required in the application is justification for the denial, suspension, or revocation of my registration by the Board.
SIGNATURE OF THE SUPERVISING EMBALMER
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PART II – SUPERVISING FUNERAL DIRECTOR
-Supervising Funeral Directors must have been employed as a licensed funeral director at least 3 years prior to the supervision.
- Supervising Funeral Directors
must provide direct supervision, which shall mean a licensed supervisor present
in the same room as apprentice during arrangements, or conducting funeral services.
When did you become licensed as a Funeral Director?__________________________________________
SIGNATURE OF THE SUPERVISING DIRECTOR
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PART IV – CERTIFICATION OF FUNERAL ESTABLISHMENT
This section of the application must be completed and signed by the Funeral Director in Full and Continuous Charge (FDFCC) of the funeral establishment.
_________________________________________________________
______________________
PRINT NAME OF FDFCC
PRINT NAME OF FUNERAL ESTABLISHMENT
___________________________________________
____________________________________________
DATE ESTABLISHMENT LICENSE WAS ISSUED
EXPIRATION DATE OF ESTABLISHMENT LICENSE
-The funeral establishment has had no violations in the last three inspections. (Rule 250-4-.06(1)(b))
-The funeral establishment has embalmed an average of at least 30 bodies per year over the preceding five years,
OR
The funeral establishment has embalmed a minimum of 150 bodies to date. (Rule 250-4-.06(1)(c))
SIGNATURE OF THE FDFCC
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PART V – AUTHORIZATION FOR BACKGROUND INVESTIGATION
I authorize the Georgia State Board of Funeral Service to conduct a background investigation of me to determine my suitability for a registration. I give my consent for full and complete disclosure of all records and information concerning myself to the Board or authorized representatives, whether such records and information are of a public, private, or confidential nature, to include criminal history records.
_____________________________________
______________
____________________________
Full Name Printed
Sex
Race
Social Security Number
Date of Birth
Street Address
Home Phone Number
City, State, Zip Code
Work Phone Number
Signature
Date
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Completing the Georgia Funeral Service Apprenticeship form is a necessary step for those looking to begin their apprenticeship in the funeral service industry. This process involves providing personal information, educational background, and details about your supervising embalmer and funeral director. Following the steps carefully will help ensure that your application is complete and submitted correctly.
The Georgia Funeral Service Apprenticeship form is an application used by individuals seeking to register as funeral service apprentices in Georgia. It outlines the necessary steps, requirements, and fees involved in the registration process.
Applicants must be at least 18 years old on the date the Board receives their application. This is a strict requirement, and proof of age may be requested.
Applicants must provide a copy of their high school diploma or GED certificate along with their application. This documentation serves to verify that the applicant has completed the necessary educational requirements.
The apprenticeship lasts a minimum of 18 months and requires a total of 3,120 hours of service. The registration is valid for two years and can be renewed twice if necessary.
Any change in apprenticeship site or supervisor will immediately terminate the current apprenticeship. You must then submit a new application for approval by the Board.
Yes, there are non-refundable fees associated with the application. The fees are as follows:
Apprentices are required to complete report forms, which can be obtained from the Board office or the Board’s website. It is the apprentice's responsibility to maintain accurate records of their service hours and activities.
To avoid delays, carefully review your application before submission. Ensure that all required information is complete and accurate. Incomplete applications will not be processed and will lead to unnecessary waiting times.
Detailed information about the apprenticeship requirements can be found in Board Rule, Chapter 250-4. This rule is available for review on the Georgia State Board of Funeral Service's official website.
Incomplete Applications: Many applicants fail to review their forms thoroughly. Incomplete applications will lead to delays in processing. Ensure all sections are filled out accurately.
Missing Documentation: Applicants often forget to attach required documents, such as a high school diploma or GED certificate. Double-check that all necessary attachments are included before submission.
Incorrect Fees: Submitting the wrong application fee is a common mistake. Refer to the fee listing carefully and ensure that the correct payment is included with your application.
Age Verification: Some applicants do not confirm their age before applying. You must be at least 18 years old when your application is received by the Board.
Failure to Update Changes: If there are changes in your apprenticeship site or supervisor, applicants often neglect to submit a new application. Remember, any changes terminate the current apprenticeship immediately.
The Georgia Funeral Service Apprenticeship form is a crucial document for individuals seeking to begin their journey in funeral service. Along with this form, there are several other documents that may be required or beneficial during the apprenticeship process. Below is a list of commonly used forms and documents that you may encounter.
Gathering and submitting these documents accurately will help ensure a smooth application process. It is important to review each requirement carefully and seek assistance if needed. Your commitment to fulfilling these obligations is a vital step toward a successful career in funeral service.
The Georgia Funeral Service Apprenticeship form shares similarities with the application forms used for various professional apprenticeships, such as those in healthcare, construction, and culinary arts. Each of these forms typically requires applicants to provide personal information, including their age, education, and prior experience. They also often include sections for supervisors or mentors to verify the applicant’s qualifications and readiness for the apprenticeship. This ensures that the applicant meets the necessary criteria before beginning their training in a regulated field.
Another document comparable to the Georgia Funeral Service Apprenticeship form is the application for a medical residency program. Both forms require candidates to demonstrate their educational background and any relevant certifications. They also necessitate the submission of recommendation letters from licensed professionals in the field. This process helps to ensure that candidates possess the required knowledge and skills to succeed in their respective fields, as both professions demand a high level of competence and ethical standards.
The application for a teaching certification can also be likened to the Georgia Funeral Service Apprenticeship form. Both documents require proof of educational qualifications, such as a degree or diploma, and may ask for a background check. Additionally, they often include a section for a mentor or supervisor to affirm the applicant's readiness for the role. This ensures that candidates have the necessary training and oversight as they begin their professional journey.
Forms used for apprenticeships in the skilled trades, such as plumbing or electrical work, exhibit similar characteristics to the Georgia Funeral Service Apprenticeship form. These applications require applicants to provide personal details, educational history, and sometimes proof of prior experience. They also include sections for supervisor endorsements to confirm that the applicant has received appropriate training and is ready to start their apprenticeship under qualified supervision.
The application for a nursing program also shares similarities with the Georgia Funeral Service Apprenticeship form. Both require applicants to provide evidence of their educational background and any relevant certifications. They typically include sections for recommendations from licensed professionals, as well as a commitment to uphold ethical standards in practice. This helps ensure that candidates are prepared for the responsibilities they will face in their respective fields.
Similar to the Georgia Funeral Service Apprenticeship form, the application for a law enforcement academy requires candidates to disclose personal information, educational qualifications, and any prior experience in related fields. Both forms also necessitate background checks and may include a section for endorsements from current professionals in the field. This is crucial for ensuring that candidates possess the integrity and character necessary for roles that involve public trust and safety.
The application for a veterinary technician program bears resemblance to the Georgia Funeral Service Apprenticeship form as well. Both require proof of educational credentials and may ask for documentation of hands-on experience in the field. They often include sections for supervisors to attest to the applicant’s skills and readiness for the profession, ensuring that candidates are well-prepared for the demands of their respective careers.
Another comparable document is the application for a culinary apprenticeship. Both forms require applicants to provide details about their educational background and any previous culinary experience. Additionally, they often include sections for chef mentors to confirm the applicant’s skills and readiness to enter the apprenticeship. This helps to maintain high standards in the culinary profession, similar to those upheld in funeral service.
Finally, the application for a cosmetology license is similar to the Georgia Funeral Service Apprenticeship form. Both require candidates to submit proof of their educational background and completion of required training hours. They also necessitate endorsements from licensed professionals to verify the applicant's qualifications. This process ensures that candidates are adequately prepared to enter their respective fields and provide quality services to the public.
When filling out the Georgia Funeral Service Apprenticeship form, it's essential to follow specific guidelines to ensure your application is processed smoothly. Here are four things you should and shouldn't do:
Misconceptions about the Georgia Funeral Service Apprenticeship form can lead to confusion and delays. Here are ten common misunderstandings:
Understanding these misconceptions can help streamline the application process and ensure compliance with the Georgia State Board of Funeral Service regulations.