Cook Apprenticeship Certification Application

Food and Service Resource Group - Training, Developing, Consulting



	Please Note: Supporting materials, such as copies of your industry certificates may be faxed to (604) 215-9565. Your cheque or money order, payable to: Food and Service Resource Group may be mailed to: Food & Service Resource Group 207-524 Powell St. Vancouver, BC V6A 1G4 Phone: (604) 215-9595 Toll Free: 1 (877) 215-9595 Fax:(604) 215-9565 Email us: certification@ foodandservice.net If you prefer you may also download this application form as a PDF file (100kb) and submit it to us with your supporting documents.

Please note that in order to meet the requirements for this program you must adhere to the following criteria:

1. Must be currently employed as a professional cook.
2. Your Chef/Supervisor must be available to confirm in-house training.
3. Must have Food Safe Level 1 prior to challenging the practical and theory evaluation.

Fields marked with an are required.

Please indicate level of certification requested:

One Two Three

Personal Information

First Name:

Initial:

Last Name:

Street Address:

City/Town:

Province:

Postal Code:

Home Phone:

Telephone number format: 999 999 9999

Work Phone:

Fax:

Email:

Employment Information

Place of Employment:

Street Address:

City/Town:

Province:

Postal Code:

Supervisor's Name/Title:

Supervisor's Phone:

Supervisor's Email:

Experience in Occupation

Please list places of employment beginning with the most recent.

#1 Place of Employ.:

Address:

How Long:

From:

To:

Full-Time Part-Time

#2 Place of Employ.:

Address:

How Long:

From:

To:

Full-Time Part-Time

#3 Place of Employ.:

Address:

How Long:

From:

To:

Full-Time Part-Time

#4 Place of Employ.:

Address:

How Long:

From:

To:

Full-Time Part-Time

Industry Skills Certificates

Please indicate which of the following industry certificates you have already obtainded. To support this information, please fax a copy of each of these, citing your name and reference ###### to (604) 696-9097.

Food Safe Level 1

Yes No

Date of certificate:

mm/dd/yyyy

Proof of Food Safe Certification (minimum Level 1) must be submitted or you will be required to complete the course prior to challenging the Theory and Practical Evaluation.

Post-Secondary Cook Training

Yes No

Institution:

Fee
Registration and Certification	$250
7% GST	$17.50

Total	$267.50
Payable to: Food and Service Resource Group
Please indicate method of payment	Cheque Money Order

I understand and agree to participate in the Cook Apprenticeship Certification program. I authorize FSRG to release the results of my Theory and Practical assessment tests to both my employer and the Industry Training Branch.