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The Georgia Funeral Service Apprenticeship form is a critical document for individuals seeking to begin their careers in funeral service. This form outlines the necessary steps and requirements for initial registration, as well as any changes in location or supervisor. Applicants must be at least 18 years old and provide proof of education, such as a high school diploma or GED. The apprenticeship requires a commitment of 3,120 hours over a minimum of 18 months, under the supervision of licensed professionals in a Board-approved establishment. It is essential to complete the application accurately, as incomplete submissions will lead to delays. The form also details the fees associated with registration and changes, emphasizing that these fees are non-refundable. Applicants must understand the importance of maintaining accurate records and reporting their progress to ensure compliance with Board regulations. Any changes in supervision or location necessitate a new application, reinforcing the structured nature of this apprenticeship process.

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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.

 

 

- 1 -

GEORGIA STATE BOARD OF FUNERAL SERVICE

237COLISEUM DRIVE MACON, GA 31217

478.207.1460 FAX 478.207.1468

www.sos.state.ga.us/plb/funeral

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

Non Refundable

(

)

Change in Supervising Embalmer&/Or Funeral Director Only

$

20.00 Non Refundable

(

)

Reinstatement of Apprenticeship Registration # ___________

$180.00

Non Refundable

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

LICENSE NUMBER

________________________________________________________________________

 

SUPERVISING EMBALMER

LICENSE NUMBER

- 2 -

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:________________

(

)

Yes

(

)

No

Have you ever been registered you as an Apprentice in this state?

 

 

 

 

 

 

If “Yes,” please provide your Apprentice Registration Number:________________

(

)

Yes

(

)

No

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.

(

)

Yes

(

)

No

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.

(

)

Yes

(

)

No

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?

(

)

Yes

(

)

No

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?

(

)

Yes

(

)

No

Have you knowingly failed to renew a license during an investigation or disciplinary

 

 

 

 

 

 

action?

 

 

 

 

 

 

 

(

)

Yes

(

)

No

Have you been subject to disciplinary action or had your membership revoked by a

 

 

 

 

 

 

professional organization governing the practice of that profession?

(

)

Yes

(

)

No

To the best of your knowledge, is there any disciplinary action pending against you by

 

 

 

 

 

 

any licensing board or professional organization?

(

)

Yes

(

)

No

Have your been arrested, charged or sentenced for the commission of a felony or any

 

 

 

 

 

 

crime involving moral turpitude?

(

)

Yes

(

)

No

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?

(

)

Yes

(

)

No

Have you had any suit filed against you related to the practice of a profession?

(

)

Yes

(

)

No

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: _____________________

 

- 3 -

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

 

 

 

 

 

 

AFFIDAVIT

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.

STATE OF GEORGIA

 

COUNTY OF ___________________________________

______________________________________________

 

SIGNATURE OF THE SUPERVISING EMBALMER

SUBSCRIBED AND SWORN TO BEFORE ME THIS

 

 

______________________________________________

________ DAY OF _____________________, _________

PRINT NAME

_______________________________________________

______________________________________________

NOTARY PUBLIC

DATE

MY COMMISSION EXPIRES: _____________________

 

- 4 -

PART II – SUPERVISING FUNERAL DIRECTOR

INSTRUCTIONS:

-Supervising Funeral Directors must have been employed as a licensed funeral director at least 3 years prior to the supervision.

-One supervisor may not supervise more than 4 apprentices.

- 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?__________________________________________

OTHER APPRENTICES CURRENTLY SUPERVISING

NAME

 

REGISTRATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

AFFIDAVIT

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.

STATE OF GEORGIA

 

COUNTY OF ___________________________________

______________________________________________

 

SIGNATURE OF THE SUPERVISING DIRECTOR

SUBSCRIBED AND SWORN TO BEFORE ME THIS

 

 

______________________________________________

________ DAY OF _____________________, _________

PRINT NAME

_______________________________________________

______________________________________________

NOTARY PUBLIC

DATE

MY COMMISSION EXPIRES: _____________________

 

- 5 -

PART IV – CERTIFICATION OF FUNERAL ESTABLISHMENT

INSTRUCTIONS:

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

 

LICENSE NUMBER

_________________________________________________________

______________________

PRINT NAME OF FUNERAL ESTABLISHMENT

 

LICENSE NUMBER

___________________________________________

____________________________________________

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))

AFFIDAVIT

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.

STATE OF GEORGIA

 

COUNTY OF ___________________________________

______________________________________________

 

SIGNATURE OF THE FDFCC

SUBSCRIBED AND SWORN TO BEFORE ME THIS

 

 

______________________________________________

________ DAY OF _____________________, _________

PRINT NAME

_______________________________________________

______________________________________________

NOTARY PUBLIC

DATE

MY COMMISSION EXPIRES: _____________________

 

- 6 -

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

- 7 -

Form Specifications

Fact Name Details
Governing Body Georgia State Board of Funeral Service
Location 237 Coliseum Drive, Macon, GA 31217
Contact Number 478.207.1460
Application Fee $40.00 for initial apprenticeship, $20.00 for changes, $180.00 for reinstatement
Minimum Age Applicants must be at least 18 years old
Education Requirement A high school diploma or GED Certificate is required
Apprenticeship Duration Minimum of 18 months, with 3120 hours of service
Supervision Requirement Must be under a Board-approved embalmer and funeral director
Change of Supervisor Any change terminates the apprenticeship; a new application is required

Georgia Funeral Service Apprenticeship: Usage Guidelines

Filling out the Georgia Funeral Service Apprenticeship form is an important step for those looking to begin their apprenticeship in funeral service. Make sure to follow each step carefully to ensure your application is complete and accurate.

  1. Visit the Georgia State Board of Funeral Service website to review Board Rule, Chapter 250-4, which outlines apprenticeship requirements.
  2. Gather necessary documents, including a copy of your high school diploma or GED certificate.
  3. Determine the appropriate application fee based on your reason for applying (initial registration, change in site, etc.). Make your payment by check or money order to the Georgia State Board of Funeral Service.
  4. Fill out Part I of the application form with your personal information, including your full name, address, telephone number, and Social Security number.
  5. If applicable, provide your current apprenticeship registration number for changes in site or supervisor.
  6. Answer all questions regarding your current registration status, education, and any past professional licenses. Attach additional sheets if necessary.
  7. Sign and date the affidavit at the end of Part I, confirming that your information is true and complete.
  8. Have your supervising embalmer complete Part II of the application, including their signature and notarization.
  9. Have your supervising funeral director complete Part III of the application, including their signature and notarization.
  10. If applicable, have the funeral director in full and continuous charge complete Part IV, ensuring all signatures are notarized.
  11. Review the entire application for completeness and accuracy before submitting it to the Board office.
  12. Mail your completed application and payment to the Georgia State Board of Funeral Service at the address provided on the form.

Your Questions, Answered

What is the purpose of the Georgia Funeral Service Apprenticeship form?

The Georgia Funeral Service Apprenticeship form is used for individuals seeking to register as Funeral Service Apprentices in Georgia. It is necessary for those who wish to gain hands-on experience in the funeral service industry under the supervision of licensed professionals. The form also facilitates any changes in apprenticeship location or supervisor.

What are the requirements to apply for the apprenticeship?

To apply for the apprenticeship, applicants must meet several requirements. Firstly, you need to be at least 18 years old on the date your application is received by the Board. Additionally, you must attach a copy of your high school diploma or GED certificate. There is also a non-refundable application fee that varies based on the type of application you are submitting. Ensure your application is complete to avoid delays in processing.

How long does the apprenticeship last?

The apprenticeship lasts a minimum of 18 months and requires a total of 3,120 hours of service, which is equivalent to full-time work over that period. The registration is valid for two years and can be renewed twice if needed. Keep in mind that this time does not include any educational requirements needed to graduate from a funeral service college.

What happens if I need to change my apprenticeship location or supervisor?

If you need to change your apprenticeship location or supervisor, your current apprenticeship will be terminated immediately. You must then submit a new application for approval by the Board. It is important to maintain accurate records and ensure all reports are current, as they will be reviewed by the Board inspector.

What kind of supervision is required during the apprenticeship?

During your apprenticeship, you must work under the supervision of a licensed embalmer and funeral director who are both approved by the Board. The supervising professionals must have at least three years of experience in their respective fields. They are responsible for providing direct supervision, meaning they must be present in the same room while you perform tasks related to embalming and funeral arrangements.

How can I maintain records of my apprenticeship?

What should I do if my application is incomplete?

Common mistakes

  1. Failing to read the Board Rule, Chapter 250-4 before filling out the application. Understanding the requirements is crucial for a successful application.

  2. Not including the correct application fee. Ensure that the payment is made by check or money order and that you refer to the fee listing on the application.

  3. Overlooking the age requirement. Applicants must be at least 18 years old when the Board receives the application.

  4. Neglecting to attach a copy of the high school diploma or GED Certificate. This document is mandatory for the application.

  5. Submitting an incomplete application. Review the entire application carefully before submission to avoid delays.

  6. Not providing accurate apprenticeship site information. Ensure that the funeral establishment name and license number are correct.

  7. Failing to answer all questions truthfully. If any question requires a "Yes" or "No" answer, provide explanations as needed.

  8. Not obtaining the necessary signatures. All required parties must sign the application, including the supervising embalmer and funeral director.

  9. Ignoring the need for a notary public signature. The application must be notarized to be valid.

Documents used along the form

The Georgia Funeral Service Apprenticeship form is an essential document for individuals seeking to begin their apprenticeship in funeral services. Along with this form, several other documents are often required or recommended to ensure compliance with state regulations and to facilitate the apprenticeship process. Below is a list of these documents, each with a brief description.

  • High School Diploma or GED Certificate: Applicants must provide proof of education by submitting a copy of their high school diploma or GED certificate. This is a fundamental requirement for eligibility.
  • Application Fee Payment: A non-refundable application fee must accompany the apprenticeship application. Payment is typically made by check or money order payable to the Georgia State Board of Funeral Service.
  • Affidavit of Supervising Embalmer: This document must be completed by the supervising embalmer, affirming their qualifications and commitment to supervise the apprentice during the apprenticeship.
  • Affidavit of Supervising Funeral Director: Similar to the embalmer's affidavit, this document is completed by the supervising funeral director. It verifies their qualifications and willingness to oversee the apprentice's training.
  • Change of Supervision or Site Application: If an apprentice needs to change their supervising embalmer or funeral director, or their apprenticeship site, a separate application must be submitted for approval.
  • Record Keeping Forms: Apprentices are required to maintain detailed records of their hours and activities. These forms can be obtained from the Board office or downloaded from their website.

Understanding these documents and their purposes can streamline the apprenticeship process and help ensure compliance with the Georgia State Board of Funeral Service's requirements. Being prepared with the necessary paperwork is a crucial step in starting a successful career in funeral services.

Similar forms

The Georgia Funeral Service Apprenticeship form shares similarities with several other important documents related to professional licensing and apprenticeship. Here are six documents that are comparable:

  • Application for Licensure: This document requires applicants to provide personal information, educational background, and proof of qualifications, similar to the apprenticeship form's requirements for age, education, and fees.
  • Professional License Renewal Application: Like the apprenticeship form, this application includes a fee structure and requires verification of continued eligibility and compliance with professional standards.
  • Internship Agreement: This document outlines the terms of an internship, including supervision and duration, paralleling the apprenticeship form's focus on supervision and specific apprenticeship details.
  • Continuing Education Documentation: Just as the apprenticeship form mandates completion of certain hours, continuing education documentation tracks the hours and courses required to maintain professional licensure.
  • Change of Supervision Notification: This document is similar in that it requires formal notification and approval for changes in supervision, much like the apprenticeship form's stipulations for changes in site or supervisor.
  • Disciplinary Action Report: This report addresses any disciplinary issues that may affect a professional's standing, akin to the questions in the apprenticeship form regarding past disciplinary actions or criminal charges.

Dos and Don'ts

When filling out the Georgia Funeral Service Apprenticeship form, there are important dos and don'ts to keep in mind to ensure a smooth application process.

  • Do read the Board Rule, Chapter 250-4, carefully before submitting your application.
  • Do ensure you are at least 18 years old when the Board receives your application.
  • Do attach a copy of your high school diploma or GED Certificate to the application.
  • Do review your application for completeness to avoid delays in approval.
  • Don't forget to include the appropriate application fee, as it is non-refundable.
  • Don't submit an incomplete application, as this will lead to unnecessary delays.
  • Don't change your apprenticeship site or supervisor without submitting a new application.
  • Don't neglect to keep your reports current and available for review by the Board inspector.

Misconceptions

Understanding the Georgia Funeral Service Apprenticeship form can be challenging, and several misconceptions often arise. Here’s a list of common misunderstandings along with clarifications to help navigate the application process.

  • Misconception 1: The application fee is refundable.
  • In reality, all application fees are non-refundable. It's essential to ensure that your application is complete before submitting it.

  • Misconception 2: You can apply for an apprenticeship at any age.
  • You must be at least 18 years old when the Board receives your application. This age requirement is strictly enforced.

  • Misconception 3: A high school diploma or GED is not necessary.
  • To apply, you must attach a copy of your high school diploma or GED certificate. This is a mandatory requirement for registration.

  • Misconception 4: The apprenticeship duration is flexible.
  • The apprenticeship lasts a minimum of 18 months and requires 3120 hours of service. This timeframe is non-negotiable.

  • Misconception 5: You can change your supervisor without any consequences.
  • Changing your supervising embalmer or funeral director will terminate your apprenticeship immediately. A new application must be submitted for approval.

  • Misconception 6: You don’t need to keep records of your apprenticeship hours.
  • Apprentices are responsible for maintaining accurate records of their service hours. These records must be available for review by the Board inspector.

  • Misconception 7: You can work at any funeral establishment during your apprenticeship.
  • Apprentices must serve at a Board-approved establishment. Working outside of this framework is not permitted.

  • Misconception 8: The Board will automatically approve incomplete applications.
  • Applications must be complete to be approved. Incomplete submissions will lead to delays in the approval process.

  • Misconception 9: The apprenticeship can last indefinitely.
  • The apprenticeship registration is valid for two years and can be renewed twice. However, it is not meant to extend beyond this timeframe.

  • Misconception 10: The supervising embalmer and funeral director can supervise an unlimited number of apprentices.
  • Each supervising embalmer or funeral director may supervise no more than four apprentices at any given time. This limitation ensures quality supervision and training.

Key takeaways

  • Understand the Requirements: Before filling out the application, read Board Rule, Chapter 250-4. This rule explains the apprenticeship requirements in detail.

  • Check the Fees: Know the application fees. The initial apprenticeship fee is $40, while changes in location or supervisor cost $20. All fees are non-refundable.

  • Age and Education: Ensure you are at least 18 years old and attach a copy of your high school diploma or GED certificate to your application.

  • Complete All Sections: Fill out all required parts of the application. Incomplete applications will cause delays in approval.

  • Record Keeping: Maintain accurate records of your apprenticeship hours and activities. Reports must be current and available for Board inspection.

  • Notify Changes: If there is any change in your apprenticeship site or supervisor, a new application must be submitted. Changes will terminate the current apprenticeship immediately.