Provisional Certificate of Qualification – Application for Extension

Provisional Certificate of Qualification - Application for Extension

An individual holding a provisional certificate of qualification may apply to the Registrar for an extension by completing and submitting this application form. The Registrar may grant an extension of the term of a provisional certificate of qualification held by the individual if the Registrar is satisfied about the existence of extenuating circumstances outside the individual’s control preventing them from scheduling or writing the certifying examination in the trade. Extenuating circumstances include, without limitation, the existence of any barrier within the meaning of the Accessibility for Ontarians with Disabilities Act, 2005 and circumstances where the certifying examinations cannot be administered for technical or operational reasons.

Section A – Applicant Information

Name *

First

Middle

Last

Date of birth (mm-dd-yyyy) *

Gender

Preferred language

STO ID/Account# *

Cellular telephone number

Home telephone number

Business telephone number

Email address *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Section B – Declaration of Extenuating Circumstances

By signing below, I declare that there currently are or, since the issuance of my Certificate of Apprenticeship in my trade, there were extenuating circumstances outside of my control preventing me from scheduling or writing the certifying examination in my trade. I acknowledge that if I provide false or misleading information or documents to Skilled Trades Ontario, or fail to provide information or documents requested by Skilled Trades Ontario, my extension may be refused, and I may be subject to other consequences or proceedings under BOSTA.

Applicant signature *

Date signed *

Trade Code(s) & Trade Name(s) of trade extensions required *

Use the space below or attach additional documents to provide details of those extenuating circumstances *

Click or drag a file to this area to upload.

Section C – Declaration and Consent

Collection of use of personal information

Information provided in or in connection with this application is collected, used, and disclosed under the authority of the Building Opportunities in the Skilled Trades Act, 2021 (BOSTA), the Regulations under BOSTA, any by-laws made by Skilled Trades Ontario's board of directors, and other applicable laws or regulations.

Declaration of accuracy of information provided

By signing below, I declare that all information I provided or will provide to Skilled Trades Ontario in the future in, or in connection with, this application is true, accurate and complete. I acknowledge that if I provide false or misleading information or documents to Skilled Trades Ontario in this or future applications for certification under BOSTA, or fail to provide information or documents requested by Skilled Trades Ontario:

I may be denied a certificate, renewal or extension thereof;
a certificate issued to me by Skilled Trades Ontario may be suspended, revoked, or made subject to specified terms, conditions or limitations;
I may be guilty of an offense and, on conviction, liable to a fine; or
I may be subject to other proceedings, costs or consequences under BOSTA and its regulations, or any by-laws made by Skilled Trades Ontario’s board of directors, which could result in a range of penalties, including having the Registrar revoke, suspend or impose terms, conditions or limitations on certificates which Skilled Trades Ontario may issue to me.

Consent

I consent that Skilled Trades Ontario may request and receive information, documents or records about me from, and provide information, documents, or records about me to, persons who may have information relevant to this application including:

my current and former employers;
governmental bodies, organizations (including departments, ministries, boards and agencies) or officials, police forces or military authorities;
governing, regulatory, self-regulatory, apprenticeship or other trades bodies, authorities, agencies or officials;
educational or training institutions;
consumer reporting agencies;
publicly available sources under applicable laws or regulations;
any other relevant sources.

I consent that Skilled Trades Ontario may collect, use and disclose any information, documents or records provided in or in connection with this application, including personal information and confidential information, for the following purposes:

verifying the information;
assessing and processing this application;
administering my file with Skilled Trades Ontario;
administering BOSTA and its regulations, or any by-laws made by Skilled Trades Ontario’s board of directors;
conducting policy analysis, evaluation and research related to apprenticeship and trades certification;
any other purpose for which Skilled Trades Ontario requests your consent and to which you consent;
as otherwise required or permitted by law.

I consent that all information, documents or records requested by Skilled Trades Ontario for the above-noted purposes from other sources may be provided to Skilled Trades Ontario.

Skilled Trades Ontario collects, uses and discloses personal information in accordance with the Freedom of Information and Protection of Privacy Act, 1990, and sections 62 and 63 of BOSTA. The collection, use and disclosure of your personal information will be limited to only what is necessary for the purposes specified above.

Applicant signature *

Date signed *