The Georgia Funeral Service Apprenticeship Form is a crucial document for those looking to start their journey in the funeral service profession within the state of Georgia. This form serves as a comprehensive guide for applicants outlining the initial registration process, changes in location or supervisor, and the specific rules and requirements set by the Georgia State Board of Funeral Service. Understanding and accurately completing this form is essential for ensuring a smooth apprenticeship experience and compliance with state regulations.
Entering the field of funeral services in Georgia requires a comprehensive apprenticeship, seeking to prepare applicants through a structured blend of practical experience and educational groundwork. Administered by the Georgia State Board of Funeral Service, the Funeral Service Apprenticeship program outlines specific prerequisites and procedural guidelines for anyone looking to begin or modify their apprenticeship in funeral services. From the initial application, which mandates the inclusion of a non-refundable fee, evidence of age, and educational qualifications, to the meticulous details governing the apprenticeship tenure - including its commencement, mandatory hours, supervision requirements, and report submissions - the program is meticulously designed to ensure preparedness and compliance. Furthermore, the application delineates instructions for any changes in the apprenticeship’s dynamics, such as shifts in location or supervisory personnel. This detailed framework serves not only to organize the path for aspiring funeral service professionals but also underscores the significant responsibility placed on both the apprentices and their supervisors in upholding the state’s regulatory standards and the integrity of the profession.
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.
REQUIREMENTS
·
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
The date your apprenticeship begins will be determined by the date your
REGISTRATION:
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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237COLISEUM DRIVE MACON, GA 31217
478.207.1460 FAX 478.207.1468
DO NOT WRITE IN THIS SECTION
RECEIPT # _____________________
AMOUNT ______________________
APPLICANT # __________________
INITIAL _____ DATE ___________
APPLICATION FOR FUNERAL SERVICE APPRENTICESHIP
REASON FOR APPLICATION:
Make checks payable to: The GA Board of Funeral Service
(
)
Initial Funeral Service Apprenticeship
$
40.00
Non Refundable
Change in Apprenticeship Site(to include change of supervisors)
20.00
Change in Supervising Embalmer&/Or Funeral Director Only
20.00 Non Refundable
Reinstatement of Apprenticeship Registration # ___________
$180.00
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)
FIRSTMIDDLELAST
*FOR CHANGE OF SITE OR SUPERVISOR ONLY, LIST APPRENTICESHIP REGISTRATION #_________
CURRENT RESIDENCE ADDRESS
___________________________________________________________________________________________________________
STREET(INCLUDE APT/LOT #)
CITY
COUNTY STATE ZIP CODE TELEPHONE NUMBER
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
PLACE OF BIRTH:
______________________________________________
CITYSTATE OR COUNTRY
AGE: ________
DATE OF BIRTH : _______/_________/_____________
GENDER
: _____ MALE _____ FEMALE
__________
HEIGHT
WEIGHT
EYES
HAIR
APPRENTICESHIP SITE INFORMATION
________________________________________________________________________
________________________________
FUNERAL ESTABLISHMENT NAME
LICENSE NUMBER
SUPERVISING DIRECTOR
SUPERVISING EMBALMER
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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:________________
Have you ever been registered you as an Apprentice in this state?
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.
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.
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?
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?
Have you knowingly failed to renew a license during an investigation or disciplinary
action?
Have you been subject to disciplinary action or had your membership revoked by a
professional organization governing the practice of that profession?
To the best of your knowledge, is there any disciplinary action pending against you by
any licensing board or professional organization?
Have your been arrested, charged or sentenced for the commission of a felony or any
crime involving moral turpitude?
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?
Have you had any suit filed against you related to the practice of a profession?
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
DATE
MY COMMISSION EXPIRES: _____________________
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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 licensed 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
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.
SIGNATURE OF THE SUPERVISING EMBALMER
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PART II – SUPERVISING FUNERAL DIRECTOR
-Supervising Funeral Directors must have been employed as a licensed funeral director at least 3 years prior to the supervision.
- 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?__________________________________________
SIGNATURE OF THE SUPERVISING DIRECTOR
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PART IV – CERTIFICATION OF FUNERAL ESTABLISHMENT
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
PRINT NAME OF FUNERAL ESTABLISHMENT
___________________________________________
____________________________________________
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))
SIGNATURE OF THE FDFCC
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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
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The process of applying for a Funeral Service Apprenticeship in Georgia is meticulous, requiring careful attention to detail to ensure all requirements are met. This involves submitting accurate information about personal background, the apprenticeship site, and securing affidavits from supervising funeral service professionals. By following the steps outlined, applicants can navigate the application process more smoothly, avoiding common pitfalls that may delay their entry into the funeral service profession.
After submission, the Board will review the application. Approval is contingent upon the completeness and accuracy of the application. The Board will determine the start date of the apprenticeship once the application is approved. It is crucial to keep a copy of the submitted application and all correspondence with the Board for personal records. Regularly check the status of the application and be prepared to respond promptly to any requests from the Board for additional information or clarification.
What are the eligibility requirements for the Funeral Service Apprenticeship in Georgia?
To be eligible for the Funeral Service Apprenticeship in Georgia, applicants must meet several criteria. First, an applicant must be at least 18 years of age by the time their application is received by the Georgia State Board of Funeral Service. In addition, they are required to attach a copy of their high school diploma or GED Certificate to the application. These requirements ensure that applicants have a basic level of education and are legally considered adults, capable of undertaking the responsibilities of the apprenticeship.
How long does the apprenticeship last, and what are its key components?
The apprenticeship lasts a minimum of 18 months, during which the apprentice must complete 3120 hours of service. This tenure is designed to provide substantial experience and training in funeral service under the supervision of Board-approved embalmers and funeral directors at an established funeral service location. The apprentice is required to maintain report forms, keeping track of their service hours. These forms are available from the Board office or can be downloaded from the Board’s website. The apprenticeship also includes an initial registration period valid for two years, with the possibility of renewal twice.
What happens if there is a change in the apprenticeship site or supervisor?
Any change in the apprenticeship site or supervisor results in the immediate termination of the apprenticeship. This means if an apprentice needs to move to a different Board-approved establishment or if there is a change in the supervising embalmer or funeral director, a new application must be submitted and approved by the Board before the apprenticeship can continue. It is crucial for the apprentice to keep their reports current and be prepared for them to be reviewed by a Board inspector, highlighting the importance of thorough record-keeping throughout the apprenticeship.
What is the application fee for the Funeral Service Apprenticeship, and is it refundable?
As detailed, application fees vary based on the nature of the application—whether it is for an initial registration, a change in site or supervisors, or reinstatement. Regardless of the situation, all fees are non-refundable, committing applicants to ensure their application is thoroughly reviewed and complete before submission.
Filling out the Georgia Funeral Service Apprenticeship form is an important step in starting a career in funeral services in Georgia. However, mistakes in the application process can lead to delays or even denial of the apprenticeship. Here are nine common mistakes people make when filling out the form:
Avoiding these common mistakes can smooth the path towards beginning an apprenticeship in funeral service in Georgia. Do take the time to review each section of the application and ensure all information is accurate and complete before submission. Your attention to detail will help expedite the application process.
The journey into the funeral service profession in Georgia is a step requiring detailed attention and adherence to specific requirements, ensuring the profession maintains its high standards of practice. In parallel, various critical documents complement the Georgia Funeral Service Apprenticeship form to make this journey comprehensive and compliant with state regulations. Understanding each of these documents is pivotal to smooth navigation through the licensing and apprenticeship process.
Together, these documents form a comprehensive suite of tools and regulatory guides that support candidates throughout their apprenticeship and into their professional career within the funeral service industry in Georgia. Each serves a specific purpose in ensuring that standards are upheld and that individuals entering the profession are fully prepared to serve the community with dignity, respect, and competence. Applicants are encouraged to familiarize themselves with these documents thoroughly to ensure a seamless integration into the profession.
The Georgia Funeral Service Apprenticeship form is similar to several other regulatory documents required for professional licensure and certification within various fields. These resemblances stem from their shared objective in ensuring that applicants meet predefined standards of qualification and conduct before granting a license or certification. Each form, while tailored to its respective field, typically shares common sections that collect personal background information, educational qualifications, and professional experience. Additionally, they include sections for supervisors or mentors to verify the applicant's readiness and compliance with industry standards. Below, the similarities with two such documents are explored:
Medical Licensing Application Forms: The structure and intent behind the Georgia Funeral Service Apprenticeship form echo characteristics found in medical licensing applications. Both forms are designed to meticulously collect comprehensive information about the applicant's education, previous licensure, and practical experience. For example, medical licensing forms require details of medical school education, internship, residency, and any specialty certifications, mirroring the apprenticeship form’s requirement for educational and practical experience documentation. Both sets of forms include sections for personal declarations about past conduct and professional fitness, ensuring that applicants uphold the integrity required within their professional community. Furthermore, they often require affidavits or sworn statements to be signed in the presence of a notary, underscoring the importance of the truthfulness and accuracy of the information provided.
Engineering Intern Certification Forms: Similarly, the process and requirements outlined in the Georgia Funeral Service Apprenticeship form share parallels with engineering intern certification applications. These applications also aim to establish the foundation of an aspirant's career through a structured period of supervised practical experience, typically necessitating documentation of the applicant's education, such as a bachelor's degree in engineering. The emphasis on supervised experience is akin to the apprentice’s requirement to work under a board-approved embalmer and funeral director, aimed at fostering professional development under direct oversight. Both documents necessitate periodic reporting and may require the participants to record hours or projects completed, thereby providing a framework for continuous evaluation and mentorship. Additionally, they typically include provisions for changing supervisors or training sites, acknowledging the dynamic nature of professional growth and development.
Filling out the Georgia Funeral Service Apprenticeship Form is a crucial step towards embarking on a career in funeral service within the state. A thorough understanding and proper completion of this application can smooth the path forward. Here are key dos and don’ts to keep in mind:
By following these guidelines closely, applicants can navigate the process of applying for the Georgia Funeral Service Apprenticeship with clarity and confidence, laying a strong foundation for their future career in the funeral service industry.
Understanding the requirements and processes for becoming a Funeral Service Apprentice in Georgia is essential for those interested in the profession. However, some misconceptions can lead to confusion and delays. Here are five common misunderstandings clarified:
Clearing up these misconceptions helps ensure that candidates have a correct understanding of the apprenticeship process in Georgia, leading to a smoother application process and fostering a more professional environment in the funeral service industry.
Completing the Georgia Funeral Service Apprenticeship form requires careful attention to detail and an understanding of the specific requirements as outlined by the Georgia State Board of Funeral Service. Here are some key takeaways to ensure a smooth application process:
Understanding these key elements will help applicants navigate the application process more effectively, ensuring that all requirements are met and ultimately facilitating a successful registration as a Funeral Service Apprentice in Georgia.
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