Form 22-8864 - Other On-The-Job Training And Apprenticeship Training Agreement And Standards - Department Of Veterans Affairs
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4OMB Approved No. 2900-0342
Respondent Burden: 30 minutes
OTHER ON-THE-JOB TRAINING AND APPRENTICESHIP TRAINING AGREEMENT AND STANDARDS
(TRAINING PROGRAMS OFFERED UNDER 38 U.S.C. 3677 AND 3687)
PART I - GENERAL INFORMATION
1. NAME AND ADDRESS OF ESTABLISHMENT ENTERING INTO TRAINING
2. NAME AND ADDRESS OF TRAINEE ENTERING INTO TRAINING AGREEMENT
AGREEMENT
3. TRAINEE’S SOCIAL SECURITY NUMBER
4. TRAINEE’S VA FILE NUMBER
5. DATE OF BIRTH
6.TRAINEE’S JOB TITLE OR TRADE
7. LENGTH OF PROGRAM
8. CREDIT FOR PREVIOUS TRAINING/EXPERIENCE
9. LENGTH OF TIME REMAINING TO BE COMPLETED
10. DATE TRAINING BEGINS
11. LENGTH OF PROBATIONARY
12. FACILITY CODE
13. DOT CODE
PERIOD
FOR VA USE
ONLY
PART II - TRAINING AGREEMENT
14. SPECIFIC QUALIFICATIONS FOR TRAINEES
15. NUMBER OF TRAINEES PER INSTRUCTOR OR NUMBER
OF APPRENTICES TO JOURNEYWORKERS (Ratio)
16. WAGE PROGRESSION TOWARD THE JOURNEYWORKER WAGE
NOTE: Trainees who receive credit for previous experience shall be paid the wage rate of the period to which such credit
advances them.
A. PERIOD
B. NUMBER OF MONTHS
C. WAGE LEVEL
A. PERIOD B. NUMBER OF MONTHS
C. WAGE LEVEL
1ST
$
PER
6TH
$
PER
2ND
$
PER
7TH
$
PER
3RD
$
PER
8TH
$
PER
4TH
$
PER
9TH
$
PER
5TH
$
PER
10TH
$
PER
D. PRESENT FULLY TRAINED WAGE RATE OR JOURNEYWORKER WAGE RATE
$
PER
17A. WORK PROCESSES IN WHICH TRAINEE WILL RECEIVE INSTRUCTION OR WILL BE TRAINED
(List the various operations or tasks to be learned with a brief narrative description and the length of time
17B. NUMBER OF HOURS OF TRAINING
devoted to each. If additional space is required, please continue on a separate sheet)
TOTAL
18A. COURSE CURRICULUM UNITS, OR TRAINING OUTSIDE THE JOB NECESSARY
18B. LOCATION OF RELATED TRAINING/INSTRUCTION
FOR THIS TRADE (If required)
The Establishment and the Trainee enter into this agreement in conformity with the Training Standards shown on the
reverse side of this form which have been approved by the Department of Veterans Affairs. Carefully read these
standards before signing below.
19. SIGNATURE OF TRAINEE
20. SIGNATURE AND TITLE OF ESTABLISHMENT DESIGNEE
The signing of this agreement binds the parties to compliance with the Agreement and Training/Apprenticeship
Standards.
VA FORM
SUPERSEDES VA FORM 22-8864, AUG 1998,
22-8864
MAR 2004
WHICH WILL NOT BE USED.
COPY 1
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