Ministry of Training,

Colleges and Universities

Application for Certificate of Qualification

Clear Form

By making this Application for Certificate of Qualification, you are authorizing the Ministry of Training, Colleges and Universities to verify any information
provided. Before completing this application form, please read the guidebook. The guidebook will help you to complete this application successfully. The
guidebook is available from your nearest apprenticeship office or call the Employment Ontario Hotline (toll-free: 1 800 387-5656; TTY: 1 866 768-1157;
Toronto: 416 326-5656) or go to http://www.edu.gov.on.ca/eng/tcu/employmentontario/training/

Section A: Trade Information

In what trade are you applying for a Certificate of Qualification?

Have you ever been registered as an apprentice in Ontario?

No

If yes, in what trade?

Yes

Contract or Training Agreement Number

Certificate of Apprenticeship Number

Do you hold a Certificate of Qualification in the above trade issued in another province or territory of Canada?
Certificate of Qualification Number

Yes

No

If applicable, what is the Red Seal Number?

Date of Issue (yyyy/mm/dd)

Province or territory of issue

QC

NB

NS

PE

NL

MB

SK

AB

BC

NT

YT

NU

Do you hold a Certificate of Qualification issued by Ontario in another skilled trade?

No

Yes

If yes, in what trade?

Certificate of Qualification Number

If applicable, what is the Red Seal Number?

Date of Issue (yyyy/mm/dd)

Do you hold a Certificate of Qualification issued by another country or non-Canadian jurisdiction in this or another trade?
No

Yes

If yes, in what trade?

Certificate of Qualification Number

Date of Issue (yyyy/mm/dd)

If yes, from what country?

Section B: Personal Information

First Name

Middle Name

Preferred First Name

Gender
Male

Female

Preferred Language
English
French

Cell Telephone Number

Street Number

Date of Birth (yyyy/mm/dd)

Social Insurance Number

Home Telephone Number

Business Telephone Number

Email Address

Street Name

City/Town

Unit Number
Province

Do you wish to self identify as a member of a designated group?

Your response to this question is entirely voluntary and will not
affect your eligibility for certification. The information will be used
by Canada and Ontario for policy analysis and statistical purposes
related to employment programs and services.

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Last Name

Queens Printer for Ontario, 2011

First Nations

Postal Code

Mtis

Persons with Disabilities

Country

Inuit
Visible Minority

Newcomer to Canada; if yes, how long?

Disponible en franais

PO Box

Months

Years

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Section C: Work Experience in the Trade (Red Seal holders and Reciprocal applicants are not required to complete this section)
Employment 1 - Start with your most recent trade-related position
What is/was your job title?

Work Start Date (yyyy/mm/dd)

Work End Date (yyyy/mm/dd)

Provide a detailed description of your duties while working with this employer. Please describe skills, tools, equipment, types of projects, customers, etc. (if you
need more space, please attach an extra page)

Legal Name of Employer

Operating Name of Employer (if different from legal name)
Street Number

Street Name

City/Town

Unit Number
Province

Telephone Number

Email Address

Postal Code

PO Box

Country

Website

Total Number of Hours Worked

Name of Contact Person (This person should be able to verify your description of job duties.)
Last Name

First Name

Work Telephone Number

Work Email Address

Job Title

What language does this contact person speak?

English

French

Other: Please specify _____________________

Employment 2
What is/was your job title?

Work Start Date (yyyy/mm/dd)

Work End Date (yyyy/mm/dd)

Provide a detailed description of your duties while working with this employer. Please describe skills, tools, equipment, types of projects, customers, etc. (if you
need more space, please attach an extra page)

Legal Name of Employer

Operating Name of Employer (if different from legal name)
Street Number

Street Name

City/Town
Telephone Number

Unit Number
Province

Email Address

Postal Code

PO Box

Country

Website

Total Number of Hours Worked

Name of Contact Person (This person should be able to verify your description of job duties)
Last Name
Work Telephone Number

First Name
Work Email Address

What language does this contact person speak?

English

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Job Title

French

Other: Please specify _____________________

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Employment 3
What is/was your job title?

Work Start Date (yyyy/mm/dd)

Work End Date (yyyy/mm/dd)

Provide a detailed description of your duties while working with this employer. Please describe skills, tools, equipment, types of projects, customers, etc. (if you
need more space, please attach an extra page)

Legal Name of Employer

Operating Name of Employer (if different from legal name)
Street Number

Street Name

Unit Number

City/Town
Telephone Number

Province
Email Address

Postal Code

PO Box

Country

Website

Total Number of Hours Worked

Name of Contact Person (This person should be able to verify your description of job duties.)
Last Name
Work Telephone Number

First Name

Job Title
What language does this contact person speak?

Work Email Address

English

French

Other: Please specify _____________________

Section D: Formal Instruction (Education)

Describe any formal instruction (courses, classes, academic training) you have had in the trade you have applied for. Please start with the most recently
completed (if you need more space, please attach an extra page).

Formal Instruction 1
Course or Program Name
Name of educational or training institution (e.g. college, technical college, private career college, union training centre, university, etc.)
City/Town
Start Date (yyyy/mm/dd)

Province/State
End Date (yyyy/mm/dd)

Country

Length of Course

Did you successfully complete the course or program?

Yes

No

Formal Instruction 2
Course or Program Name
Name of educational institution (e.g. college, technical college, private career college, union training centre, university, etc.)
City/Town
Start Date (yyyy/mm/dd)

Province/State
End Date (yyyy/mm/dd)

Country

Length of Course

Did you successfully complete the course or program?

Yes

No

Declaration of Truth and Accuracy

By signing below, I declare that the information contained in this application and all required supporting documentation is true and complete. I
have read and understood the instructions and conditions for a Certification of Qualification. I understand that if I fail to provide true and complete information: i) I may not be eligible to write the Certification of Qualification exam; ii) any Certificate of Qualification that I may receive
after writing the Certificate of Qualification exam may be suspended or revoked; iii) I may be guilty of an offence and on conviction may be
liable to a fine.

Notice of Collection of Personal Information and Consent

Your personal information, including your Social Insurance Number, provided on this form and in all other communications related to your
application for and issuance of a Certificate of Qualification (C of Q) under the Apprenticeship and Certification Act, 1998 (ACA) or the
Trades Qualification and Apprenticeship Act (TQAA) will be used by:

The Ministry of Training, Colleges and Universities (the Ministry) to administer, enforce and finance the ACA and the TQAA. This includes
processing or collecting your payment and issuing a receipt for your payment; verifying your application; administering the examination in your
trade; issuing a C of Q; enforcing the legislation set out below; conducting inspections and investigations; conducting policy analysis,
evaluation and research related to all aspects of apprenticeship and certification and reporting to the public on apprenticeship and certification.

12-1535E (2011/01)

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You may be contacted to request your voluntary participation in surveys and public relations campaigns related to apprenticeship and
certification. On the request of any person, the Ministry will disclose whether you hold a C of Q; your trade, other occupation or skill set;
any terms, conditions and limitations imposed on your C of Q; and any revocation, cancellation or suspension of your C of Q. The
Ministry may be required to disclose your personal information to Statistics Canada under s. 13 of the Statistics Act, R.S. 1985, c. S-19,
as amended.

The Ministry of Government Services to process your payment of the fee or to collect your payment if you fail to make it.

The Ministry of Labour to investigate and enforce workplace safety under the Occupational Health and Safety Act and under agreement
with the Ministry.

The Ministry of Transportation to conduct investigations and enforce the provisions of the Highway Traffic Act relating to motor vehicle
inspection mechanics.

The College of Trades to administer and enforce the Ontario College of Trades and Apprenticeship Act, 2009.
The ministries may use contractors, auditors or other third party administrators including collection agencies, for any of these activities.
Your personal information is collected under the authority of ss. 9, 11, 12, 16, 17 and 18 of the ACA, S.O. 1998, c. 22, as amended; ss. 7,
18-24 of the TQAA, R.S.O. 1990, c. T.17, as amended; the Labour Market Development Agreement between Canada and Ontario and other
statutes and regulations set out in the guidebook.
If you have questions about the collection, use and disclosure of your personal information, please contact an Information Counsellor at the
Employment Ontario Hotline at 416 326-5656 or 1 800 387-5656 (TTY 416 325-4084 or 1 866 533-6339) or
http://www.edu.gov.on.ca/eng/about/contact.asp or write to the Public Inquiries Unit at Ministry of Training, Colleges and Universities, 880 Bay
Street, 2nd Floor, Toronto, Ontario M7A 1N3.
By signing below, you give consent to the Ministry to exchange necessary personal information about you with the ministries listed above, the
College of Trades, any persons or organizations identified in connection with this application and any other persons or organizations who may
have information relevant to the verification of the information you have provided in connection with this application.
Signature
Date (yyyy/mm/dd)

X
For ministry use only
TOSS Code

Trade Name

Client ID

Initial Meeting Date (yyyy/mm/dd)

Initial Meeting Conducted by (print name)

Approved to write the exam

Date (yyyy/mm/dd) ____________________

Affirmation of Skills attached

Reciprocal (OLMA)

Primary proof of work experience attached (use codes)

DOST (to be completed prior to examination)

Date (yyyy/mm/dd) ____________________

LOP/PC issued

Grandparent provision

Application rejected

Keyed into EOIS

Reason for rejection (use codes)

Comments

Receipt Number

Revenue Report

Ministry Staff Name (Please print)

Authorization Number

Amount Received

Date Received (yyyy/mm/dd) Service Type

Ministry Staff Signature

Initials

Date (yyyy/mm/dd)

X
Codes
Primary proof of work experience
LE Letter of support
TS Training Standard
RS Interprovincial Red Seal same trade
MT Matched trade (OLMA)
OT Other (trade/work experience documentation)

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Reasons for rejection

IA Incomplete application
UE Unverifiable evidence
DR Document requirements not met
UC Unable to contact
NI No longer interested
DF DOST failure
DC Deceased
OT Other (specify in Comments section above)

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