Registration Form

Apprenticeship Program

Application Form

Personal information
Name: _______________________________________________
Address: ____________________________________________
City: ___________________________ State: _________ Zip: _________________
Email:_____________________ Website____________________________________

References
Name: _____________________________ Address: _________________________
City, state, ZIP: ___________________________ Telephone: _________________
Relationship to you: _____________________________________________________
Name: _____________________________ Address: ___________________________
City, state, ZIP: ___________________________ Telephone: __________________
Relationship to you: ______________________________________________________
Name: _____________________________ Address: ___________________________
City, state, ZIP: ___________________________ Telephone: ___________________
Relationship to you: _______________________________________________________

Non-refundable application/processing fee: $25
We prefer personal check or money order. Please include payment with this form. You
can mail it to:

CAT
Attn: Apprenticeship Program Coordinator
455 W. 1st Ave.
Eugene, OR 97401

Signature: _______________________________________ Date: ______________