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Employer Details

Employer Name(Required)

Business Name(Required)

Business ABN(Required)

Phone Number(Required)

Email(Required)

Address(Required)

Suburb(Required)

Apprentice Details

Apprentice Name(Required)

Date of Birth(Required)

Address

Phone Number(Required)

Email(Required)

USI Number

Intended Qualification(Required)

Preferred RTO/TAFE

Start Date of Employment(Required)

Additional Information

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Acknowledgement of Country

The Chamber of Commerce and Industry WA (CCIWA) & Apprenticeships Services Australia (ASA) acknowledges the traditional custodians of Australia and their continuing connection to land, sea and community. We pay our respects to the people, the cultures and the elders past, present and emerging.

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