SAA-201 OJT - APPLICATION REV.DOC

ARIZONA DEPARTMENT OF VETERANS' SERVICES
State Approving Agency (SAA)
APPLICATION FOR APPROVAL – ON THE JOB TRAINING (OJT)
Date of Application_________________
IDENTIFICATION
Name of Establishment or Sponsor
Address Telephone
Address where records will be kept Telephone
Name and Title of Contact Person(s) Telephone
FAX Number: E-Mail:
Institutional profit/ownership status: ____________________________________________________________________
(Public, Proprietorship, Partnership, Corporation for Profit, Corporation Nonprofit, etc.).
TRAINING PROGRAM
Job Title (Position for which training will be provided): __________________________________________________
Length of Program (Indicate hours / months): _____________________ Hours in Standard Work Week: _______
A. ON-THE-JOB TRAINING (OJT) PROGRAM REQUIREMENTS:
1. Attach a training outline listing the major tasks to be learned and indicating the appropriate hours allocated to each task and
total program length in hours and months (not less than six months and not more than two years).
2. Attach an outline of supplemental related theoretical training, if required, which includes the courses, subjects, and/or areas of
study required as part of the OJT Program (including the number of hours per subject). Indicate the manner in which the
instruction is to be given (classroom, correspondence, etc.). Provide the length in hours, the schedule of attendance if by
classroom, or schedule of completion of lessons if by correspondence. Provide the name and address of the agency providing
the instruction if different from the employer or sponsor. (Related training is optional for OJT programs).
3. Wage schedule to be paid the OJT trainee:
1st Period: $___________ per hour/week/month for __________ months/hours
2nd Period: $___________ per hour/week/month for __________ months/hours
3rd Period: $___________ per hour/week/month for __________ months/hours
4th Period: $___________ per hour/week/month for __________ months/hours
5th Period: $___________ per hour/week/month for __________ months/hours
6th Period: $___________ per hour/week/month for __________ months/hours
7th Period: $___________ per hour/week/month for __________ months/hours
8th Period: $___________ per hour/week/month for __________ months/hours
9th Period: $___________ per hour/week/month for __________ months/hours
10th Period: $___________ per hour/week/month for __________ months/hours
Present Journeyworker/Qualified Worker Wage Rate: $_______________ per hour/week/month.
VETAA-201
Jul 2014

NOTE: A progressively and increasing wage scale schedule must be established for the OJT Program. The employer’s starting
wages to an eligible veteran beginning training on-the-job shall not be less than the wages paid to non-veterans trainees in the
same training position. The entry wage paid the veteran must be at least 50% of the wage paid to a trained worker in the job.
Wages must be increased on a regular schedule until the veteran is receiving 85% of the wages for the job, for which he/she is
being trained, by at least the last full month of training. There must be at least one wage increase during the training program.
EXCEPTION: This increasing wage scale requirement does not apply to OJT programs being offered by federal, state, and local
governments.
1. Attach the requirements for acceptance into the OJT program.
2. The ratio of OJT trainees to journeymen/trained workers is one OJT trainee for every _____ journeymen/trained worker.
3. Number of fully qualified employees available as instructors for each trainee __________________.
4. Does the establishment or job site have, or have access to, training space/areas, all materials, tools, equipment, and facilities
to provide adequate and safe training and supervision in keeping with the training outline? Yes____ No____
5. Attach a copy of the certificate of completion, or other official record or document, which will be awarded to the OJT trainee at
the end of training. This document will indicate the satisfactory completion of the OJT program described in this application.
B. CONDITIONS
Upon approval for the training of veterans, I understand and agree to the following:
1. Close supervision by qualified journeyworkers will be provided throughout the training program.
2. The State Approving Agency will be notified of any changes to the approved OJT program(s), including training outlines, wage
schedule, training sites, etc.
3. There is reasonable certainty that the job for which the veteran is being trained will be available to them at the end of the
training period;
4. Appropriate credit will be given for previous experience or training and the beginning wage and training adjusted accordingly.
An Enrollment Certification will not be submitted for a veteran or eligible person who is already qualified for the position because
of prior training or experience.
5. A copy of an approved Training Agreement, including the training outline and wage schedule, will be provided to the trainee
and to the Department of Veterans Affairs (VA).
6. Immediately notify VA of any wage increase (or decrease) paid any trainee not in accordance with his or her training
agreement.
7. Records will be maintained for each trainee that will include the following: job assignments, promotions, demotions, lay-off
terminations, rates of pay, verification of hours worked and wages paid, and the progress in training as outlined in the work
processes. The records will be retained for at least three years following the completion of the OJT program and, upon request,
made available for review by representatives of the Department of Veterans Affairs (DVA) and the State Approving Agency
(SAA).
8. If required for approval of a training program, the trainee will be advanced to the full journeyworker wage immediately upon
completion of the training program.
9. Representatives from the Department of Veterans Affairs (VA) and the Arizona Office of Veterans’ Education will be permitted
to visit the training institution for the purpose of reviewing records, interviewing students, inspecting facilities, and evaluating the
instructional processes.
10. The training program and wage schedule submitted with this application is in conformity to state and federal standards for
Apprenticeship/On-the-Job Training, and is, to the best of my knowledge and belief, an accurate and complete plan of what this
institution will follow.
11. Certification that the trainee receives a signed copy of the training agreement and wage schedule of stated OJT position(s)
described in this application.
12. Verified that the trainee is not already fully qualified for this apprenticeship.
13. The maximum number of OJT trainees to be trained at any one time is ________.

14. Requested program approval date: __________________________
15. Certification that the trainee receives a signed copy of the training agreement and wage schedule of stated OJT position(s)
described in this application.
16. Verified that the trainee is not already fully qualified for this apprenticeship.
17. Complete and attach the enclosed VA Forms:
a. VA Form 22-8794, Designation of Certifying Officials (Refer to the instructions on the reverse side of the form)
b. VA Form 20-8206, Statement of Assurance of Compliance with Equal Opportunity Laws (Completion of this form is
self-explanatory, however, please read the form thoroughly before signing).
c. VA Form 22-8865, Employer’s Application to Provide Job Training (Completion of this from is required and should be
attached to this application).
18. All institutional advertisement (ads, published documents, website, etc) does not contain or use erroneous, deceptive or
misleading practices.
I UNDERSTAND THAT ANY DEVIATION FROM THIS AGREEMENT WITHOUT PRIOR APPROVAL BY THE STATE
APPROVING AGENCY WILL RESULT IN SUSPENSION OR DISAPPROVAL AS OUTLINED IN CFR 21.4259.
NAME
(Please print)
TITLE
SIGNATURE DATE
III. Submission
Submit this application, complete with all attachments, in one package to the following address:
Arizona Department of Veterans’ Services
State Approving Agency
3839 North 3rd Street, Suite 209
Phoenix, AZ 85012
IV. ON-SITE VISITATION
The approval process requires a complete and comprehensive institutional wide visit to ensure that all federal, state, and local
requirements are met. Once the application package has been reviewed, a representative from the State Approving Agency will
contact you to schedule the visit for initial approval. Annual visits will also be conducted to ensure approval criteria are
maintained.
Education & Training Specialist ______________________________________ Date __________________________________