Outline
The Georgia Funeral Service Apprenticeship form serves as a critical document for individuals aspiring to enter the funeral service profession in Georgia. This form outlines essential instructions and requirements that applicants must follow to secure their registration as Funeral Service Apprentices. Key aspects include the necessity of submitting a non-refundable application fee, proof of age—specifically, that the applicant is at least 18 years old—and evidence of educational attainment, such as a high school diploma or GED certificate. The form stipulates that the apprenticeship lasts a minimum of 18 months, during which the apprentice must accumulate a total of 3,120 hours of practical experience under the supervision of a licensed embalmer or funeral director at a Board-approved establishment. Additionally, any changes to the apprenticeship site or supervising personnel require a new application, highlighting the importance of maintaining accurate records throughout the apprenticeship. Applicants must also answer several questions regarding their professional history and background, ensuring that all information is truthful and complete. This comprehensive approach helps maintain the integrity of the profession and ensures that apprentices are adequately prepared for their future roles in funeral service.
Sample - Georgia Funeral Service Apprenticeship Form
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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.
REQUIREM ENTS
•
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
REGISTRATION:
The date your apprenticeship begins will be determined by the date your
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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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
APPLICATION FOR FUNERAL SERVICE APPRENTICESHIP
REASON FOR APPLICATION: Make checks payable to: The GA Board of Funeral Service
( ) Initial Funeral Service Appre nticeship $ 40.00 Non Refundable
( ) Change in Apprenticeship Site(to include change of supervisors) $ 20.00 Non Refundable
( ) Change in Supervising Embalmer&/Or Funeral Director Only $ 20.00 Non Refundable
( ) Reinstatement of Apprenticeship Registration # ___________ $180.00 Non Refundable
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)
*FOR CHANGE OF SITE OR SUPERVISOR ONLY, LIST APPRENTICESHIP REGISTRATION #_________
APPRENTICESHIP SITE INFORMATION
________________________________________________________________________
FUNERAL ESTABLISHMENT NAME
________________________________
LICENSE NUMBER
________________________________________________________________________
SUPERVISING DIRECTOR
________________________________________________________________________
LICENSE NUMBER
SUPERVISING EMBALMER LICENSE NUMBER
DO NOT WRITE IN THIS SECTION
RECEIPT # _____________________
AMOUNT ______________________
APPLICANT # __________________
INITIAL _____ DATE ___________
FIRST MIDDLE LAST
CURRENT RESIDENCE ADDRESS
___________________________________________________________________________________________________________
STREET(INCLUDE APT/LOT #) CITY COUNTY STATE ZIP CODE TELEPHONE NUMBER
PLACE OF BIRTH:
______________________________________________
CITY STATE OR COUNTRY
AGE: ________
DATE OF BIRTH : _______/_________/_____________
GENDER : _____ MALE _____ FEMALE
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
__________
HEIGHT
__________
WEIGHT
__________
EYES
__________
HAIR
- 3 -
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:________________
( )
Yes
( )
No
Have you ever been registered you as an Apprentice in this state?
If “Yes,” please provide your Apprentice Registration Number:________________
( )
Yes
( )
No
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.
( )
Yes
( )
No
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.
( )
Yes
( )
No
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?
( )
Yes
( )
No
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?
( )
Yes
( )
No
Have you knowingly failed to renew a license during an investigation or disciplinary
action?
( )
Yes
( )
No
Have you been subject to disciplinary action or had your membership revoked by a
professional organization governing the practice of that profession?
( )
Yes
( )
No
To the best of your knowledge, is there any disciplinary action pending against you by
any licensing board or professional organization?
( )
Yes
( )
No
Have your been arrested, charged or sentenced for the commission of a felony or any
crime involving moral turpitude?
( )
Yes
( )
No
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?
( )
Yes
( )
No
Have you had any suit filed against you related to the practice of a profession?
( )
Yes
( )
No
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
MY COMMISSION EXPIRES: _____________________
DATE
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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 licen
sed 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
AFFIDAVIT
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.
STATE OF GEORGIA
COUNTY OF ___________________________________
______________________________________________
SIGNATURE OF THE SUPERVISING EMBALMER
SUBSCRIBED AND SWORN TO BEFORE ME THIS
______________________________________________
________ DAY OF _____________________, _________
PRINT NAME
_______________________________________________
______________________________________________
NOTARY PUBLIC
MY COMMISSION EXPIRES: _____________________
DATE
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PART II – SUPERVISING FUNERAL DIRECTOR
INSTRUCTIONS:
-
Supervising Funeral Directors must have been employed as a licensed funeral director at least 3 years prior to
the supervision.
- One supervisor may not supervise more than 4 apprentices.
-
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?__________________________________________
OTHER APPRENTICES CURRENTLY SUPERVISING
NAME REGISTRATION NUMBER
AFFIDAVIT
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.
STATE OF GEORGIA
COUNTY OF ___________________________________
______________________________________________
SIGNATURE OF THE SUPERVISING DIRECTOR
SUBSCRIBED AND SWORN TO BEFORE ME THIS
______________________________________________
________ DAY OF _____________________, _________
PRINT NAME
_______________________________________________
______________________________________________
NOTARY PUBLIC
MY COMMISSION EXPIRES: _____________________
DATE
- 6 -
PART IV – CERTIFICATION OF FUNERAL ESTABLISHMENT
INSTRUCTIONS:
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
______________________
LICENSE NUMBER
_________________________________________________________
PRINT NAME OF FUNERAL ESTABLISHMENT
______________________
LICENSE NUMBER
___________________________________________
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))
AFFIDAVIT
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.
STATE OF GEORGIA
COUNTY OF ___________________________________
______________________________________________
SIGNATURE OF THE FDFCC
SUBSCRIBED AND SWORN TO BEFORE ME THIS
______________________________________________
________ DAY OF _____________________, _________
PRINT NAME
_______________________________________________
______________________________________________
NOTARY PUBLIC
MY COMMISSION EXPIRES: _____________________
DATE
- 7 -
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
Form Information
| Fact Name | Description |
|---|---|
| Governing Law | The application process is governed by Board Rule, Chapter 250-4. |
| Application Fees | Fees vary: $40 for initial registration, $20 for changes in site or supervisors, and $180 for reinstatement. |
| Age Requirement | Applicants must be at least 18 years old when the Board receives the application. |
| Education Requirement | A copy of a high school diploma or GED certificate must be attached to the application. |
| Apprenticeship Duration | The apprenticeship lasts a minimum of 18 months and includes 3120 hours of service. |
| Supervision Requirement | Apprentices must work under a Board-approved embalmer and funeral director at an approved establishment. |
Detailed Guide for Filling Out Georgia Funeral Service Apprenticeship
Completing the Georgia Funeral Service Apprenticeship form is an important step in your journey to becoming a registered apprentice. Make sure to gather all necessary documents and information before starting. This will help ensure that your application is complete and can be processed without delays.
- Visit the Georgia State Board of Funeral Service website to review Board Rule Chapter 250-4, which outlines apprenticeship requirements.
- Determine the application fee based on your reason for applying: $40 for initial registration, $20 for a change in site or supervisor, or $180 for reinstatement.
- Complete Part I of the application form. Provide your full name, current address, phone number, and social security number. Indicate your citizenship status and place of birth.
- Attach a copy of your high school diploma or GED certificate to the application.
- Fill out the apprenticeship site information, including the funeral establishment name and license numbers for the supervising director and embalmer.
- Answer the questions regarding your registration status, education, and any past licenses or disciplinary actions. If applicable, provide explanations and additional documentation.
- Sign the affidavit in Part I, confirming that all information provided is true and complete.
- Have the supervising embalmer complete Part II of the form. They must provide their license details and sign the affidavit.
- Have the supervising funeral director complete Part III of the form. They must also provide their license details and sign the affidavit.
- Ensure that the Funeral Director in Full & Continuous Charge completes Part IV, if applicable.
- Submit the completed application along with the payment, made out to the Georgia State Board of Funeral Service.
Once submitted, the Board will review your application. They will notify you of any additional information needed or if your application has been approved. Be prepared for potential follow-up questions or requests for documentation during this process.
Obtain Answers on Georgia Funeral Service Apprenticeship
-
What is the purpose of the Georgia Funeral Service Apprenticeship form?
The Georgia Funeral Service Apprenticeship form is used to register individuals who wish to become funeral service apprentices in the state of Georgia. This form is essential for those looking to gain practical experience under the supervision of licensed professionals in a funeral establishment.
-
What are the age and education requirements for applicants?
Applicants must be at least 18 years old on the date the Board receives the application. Additionally, a copy of a high school diploma or GED certificate must be attached to the application. This ensures that all apprentices have completed a foundational level of education before entering the field.
-
How long is the apprenticeship, and how many hours are required?
The apprenticeship lasts a minimum of 18 months and requires a total of 3,120 hours of service. This experience is crucial for gaining the necessary skills and knowledge in funeral service practices.
-
What should I do if I need to change my apprenticeship site or supervisor?
If you need to change your apprenticeship site or supervisor, you must submit a new application. The original apprenticeship will be terminated immediately upon the change. It is important to keep your records up to date and available for review by the Board inspector.
-
What fees are associated with the application?
There are several fees associated with the application process:
- Initial Funeral Service Apprenticeship: $40 (non-refundable)
- Change in Apprenticeship Site or Supervisor: $20 (non-refundable)
- Change in Supervising Embalmer or Funeral Director: $20 (non-refundable)
- Reinstatement of Apprenticeship Registration: $180 (non-refundable)
-
What happens if my application is incomplete?
It is crucial to ensure that your application is complete before submission. Incomplete applications will result in delays in the approval process. The Board only approves applications that are fully completed, so take the time to review your application carefully.
-
How can I obtain the report forms required during my apprenticeship?
Report forms can be obtained from the Board office or downloaded from the Board's website. It is the apprentice's responsibility to maintain accurate records of their service throughout the apprenticeship.
Common mistakes
Filling out the Georgia Funeral Service Apprenticeship form can be straightforward, but many applicants make common mistakes that can delay their application. One of the most frequent errors is not reading the instructions carefully. Applicants often overlook the requirement to review Board Rule Chapter 250-4, which outlines the specific apprenticeship requirements. Ignoring this step can lead to submitting an incomplete application, causing unnecessary delays.
Another common mistake is failing to provide the correct payment. The application fees are non-refundable, and applicants sometimes forget to include a check or money order made out to the Georgia State Board of Funeral Service. This oversight can result in the application being rejected outright. Always double-check the fee section to ensure the correct amount is included.
Many applicants also forget to attach necessary documents, such as a copy of their high school diploma or GED certificate. This requirement is crucial for the application to be considered complete. Without this documentation, the application will be delayed or denied. It's essential to gather all required documents before submitting the form.
Another mistake involves the age requirement. Applicants must be at least 18 years old when the Board receives their application. Some individuals mistakenly submit their forms without confirming their age on the application date. This can lead to immediate disqualification, so it’s wise to verify this detail before submission.
Lastly, applicants often fail to keep their contact information current. If there are changes in residence or phone numbers, it’s vital to update this information on the application. Incomplete or outdated contact details can hinder communication with the Board, leading to further delays. Keeping everything up to date ensures a smoother process.
Documents used along the form
When applying for the Georgia Funeral Service Apprenticeship, several additional forms and documents may be required to ensure compliance with state regulations. Below is a list of commonly used documents that accompany the apprenticeship form. Each document plays a vital role in the application process.
- High School Diploma or GED Certificate: Applicants must provide a copy of their high school diploma or GED certificate as proof of education. This documentation is essential for verifying that the applicant meets the educational requirements for the apprenticeship.
- Notarized Letter from State of Licensure: If the applicant has previously held a professional license in any state, they must submit an original notarized letter from the state of licensure. This letter confirms the status of the applicant's previous license.
- Apprentice Report Forms: These forms are required to document the apprentice's progress and hours worked during the apprenticeship. They can be obtained from the Board office or the Board's website.
- Change of Site or Supervisor Application: If there is a need to change the apprenticeship site or supervising personnel, a separate application must be submitted. This document ensures that any changes are officially recorded and approved by the Board.
- Affidavit of Truthfulness: Both the applicant and supervising professionals must complete an affidavit affirming that all information provided is accurate and truthful. This legal declaration is critical for maintaining the integrity of the application process.
Each of these documents serves a specific purpose in the application process for the Georgia Funeral Service Apprenticeship. Ensuring that all required forms are completed accurately can help facilitate a smooth application experience.
Similar forms
- Application for Licensure: Similar to the Georgia Funeral Service Apprenticeship form, this document requires personal information, proof of education, and a fee. Both forms emphasize the importance of accuracy and completeness to avoid delays in processing.
- Change of Address Form: Like the apprenticeship form, this document must be filled out completely to ensure that all information is current. It also requires a signature and may involve a fee for processing.
- Employment Application: This document, similar to the apprenticeship form, gathers personal details and qualifications. Both require applicants to provide proof of their credentials and may necessitate references.
- Professional License Renewal Application: This application shares similarities with the apprenticeship form, including the need for payment and documentation of continued education or experience in the field.
- Background Check Authorization: Like the apprenticeship form, this document requires personal information and consent for verification. Both are crucial for ensuring the applicant meets the necessary standards for the profession.
- Internship Registration Form: This form is akin to the apprenticeship application as it also requires detailed personal information, educational background, and a designated supervisor. Both forms emphasize the importance of supervision in the training process.
Dos and Don'ts
When filling out the Georgia Funeral Service Apprenticeship form, there are several important guidelines to keep in mind. Below is a list of things you should and shouldn't do to ensure a smooth application process.
- Do carefully read all instructions provided in the application form before starting.
- Do ensure that you are at least 18 years old by the time your application is submitted.
- Don't forget to attach a copy of your high school diploma or GED certificate.
- Don't submit an incomplete application, as this will lead to delays in processing.
By following these guidelines, you can help facilitate the approval of your apprenticeship application and avoid unnecessary complications.
Misconceptions
Misconceptions about the Georgia Funeral Service Apprenticeship form can lead to confusion for applicants. Understanding these misconceptions can help streamline the application process and ensure compliance with state regulations. Below are nine common misconceptions explained.
- Only high school graduates can apply. While a high school diploma or GED is required, individuals who have obtained a GED are also eligible to apply.
- Application fees are refundable. All application fees are non-refundable, regardless of the outcome of the application.
- Apprenticeship hours can be completed in less than 18 months. The minimum duration for the apprenticeship is 18 months, and it requires a total of 3120 hours of service.
- Changes in supervision do not affect the apprenticeship. Any change in the supervising embalmer or funeral director will terminate the apprenticeship immediately, requiring a new application.
- All applications are automatically approved. Applications are only approved when they are complete. Incomplete applications will lead to delays.
- Age restrictions are flexible. Applicants must be at least 18 years old on the date the Board receives the application. There are no exceptions to this rule.
- Apprentices can work at any funeral establishment. Apprentices must serve at a Board-approved establishment and under a Board-approved supervisor. This ensures compliance with state regulations.
- Documentation is optional. It is essential to attach all required documents, such as diplomas or GED certificates, as incomplete submissions will not be processed.
- Apprenticeship registration lasts indefinitely. The apprenticeship registration is valid for two years and can be renewed twice. Timely renewal is necessary to maintain status.
By addressing these misconceptions, prospective applicants can better prepare for the application process and fulfill the necessary requirements for the Georgia Funeral Service Apprenticeship.
Key takeaways
Key Takeaways for Filling Out the Georgia Funeral Service Apprenticeship Form:
- Ensure you meet the age requirement of at least 18 years old by the time your application is submitted.
- Attach a copy of your high school diploma or GED Certificate to the application.
- Review your application thoroughly before submission to avoid delays caused by incomplete information.
- Understand that the apprenticeship lasts a minimum of 18 months and requires 3120 hours of service.
- Any changes in your apprenticeship site or supervisor require a new application and will terminate your current apprenticeship.
- Keep accurate records of your apprenticeship hours and submit required reports as directed by the Board.