Apprenticeship Form - CITC Apprentice Withdrawal Request

I,

First Name(Required)

Middle Initial

Last Name(Required)

am registered with CITC’s

Trade(Required)

apprenticeship program.

My WA State Apprentice ID is:(Required)

Please Enter with 6 Digits.

Click here to lookup your WA State Apprentice ID.

I am requesting that my apprenticeship status be cancelled effective

Withdraw Date(Required)

I understand that if I am currently enrolled in CITC classes and have not notified CITC of my intent to withdraw from classes, that I will be responsible for any remaining tuition owed from the date I have notified CITC of my wish to have my apprenticeship status cancelled.

Signed:(Required)

I understand that once I am cancelled from CITC’s apprenticeship program I can no longer be employed as an apprentice.

Signed:(Required)

Today's Date(Required)

Email(Required)

Please enter email to receive a copy of your submission.

CITC Apprentice Withdraw Request