Final Competency Sign-Off

Tri-party final verification form. All four parties must sign before apprenticeship completion is documented.

Apprentice Information

Apprentice Name: ________________________________
Date of Birth: ________________________________
Apprenticeship Start Date: ________________________________
Completion Date: ________________________________
RAPIDS Registration: 2025-IN-132301
Occupation: Barber (330.371-010)

Training Site Information

Barbershop Name: ________________________________
Shop License #: ________________________________
Shop Address: ________________________________
Supervisor Name: ________________________________
Supervisor License #: ________________________________
Supervisor Phone: ________________________________

Hour Completion Verification

CategoryRequiredCompletedVerified
Related Technical Instruction (RTI)144 hours ☐
On-the-Job Training (OJT)2,000 hours ☐
Supplemental Hours (LMS, mentoring)356 hours ☐
Total Program Hours2,000 hours ☐

Competency Section Verification

SectionItemsAll ≥ 3?Verified By
S1: Sanitation, Safety & State Compliance5☐ Yes   ☐ No 
S2: Clipper & Cutting Technique5☐ Yes   ☐ No 
S3: Shaving & Razor Techniques4☐ Yes   ☐ No 
S4: Client Services & Professionalism4☐ Yes   ☐ No 
S5: Shop Operations & Business Readiness6☐ Yes   ☐ No 
S6: OJT Performance Evaluation5☐ Yes   ☐ No 
Total Competencies29☐ Yes   ☐ No 

Indiana State Board Exam Readiness

☐All required RTI hours completed and documented
☐All required OJT hours completed and verified by licensed supervisor
☐All competency rubric sections scored ≥ 3 (Competent)
☐State board exam preparation module completed in LMS
☐Practice written exam score ≥ 75%
☐Practice practical exam completed successfully
☐Apprentice recommended for Indiana PLA barber exam

Completion Determination

☐ APPRENTICESHIP COMPLETE

All hours, competencies, and evaluations verified

☐ REMEDIATION REQUIRED

Specific competencies below standard

☐ NOT COMPLETE

Hours or competencies not met

Comments / Conditions:

 

Tri-Party Verification & Sponsor Sign-Off

All four parties must sign to complete the apprenticeship record. This form is filed with RAPIDS documentation.

1. Credential Partner — RTI Instructor (Licensed Barber)

I verify that the apprentice has completed all Related Technical Instruction requirements, demonstrated competency in all RTI-assessed areas (Sections 1–3, 5), and is prepared for the Indiana state board examination.

Instructor Name: ________________________________
Indiana Barber License #: ________________________________
Training Provider: ________________________________
Date: ________________________________
Signature: ________________________________________________________________

2. Employer — Barbershop Supervisor (Licensed Barber)

I verify that the apprentice has completed all required On-the-Job Training hours under my direct supervision at a licensed barbershop, demonstrated competency in all OJT-assessed areas (Sections 4–6), and is ready for independent practice.

Supervisor Name: ________________________________
Indiana Barber License #: ________________________________
Shop Name: ________________________________
Shop License #: ________________________________
Total OJT Hours Supervised: ________________________________
Date: ________________________________
Signature: ________________________________________________________________

3. Program Holder — RTI Coordinator

I verify that all competency rubric sections have been completed and scored, all evaluation checkpoints (30-day, midpoint, final) have been conducted, and all documentation is recorded in the institutional LMS.

Program Holder Name: ________________________________
Title: ________________________________
LMS Record Verified: ☐ Yes
Date: ________________________________
Signature: ________________________________________________________________

4. Elevate for Humanity — Apprenticeship Sponsor

As the registered apprenticeship sponsor (RAPIDS ID: 2025-IN-132301), I verify that all program requirements have been met, all tri-party verifications are complete, and the apprentice is approved for completion documentation and credential pursuit.

Authorized Representative: ________________________________
Title: ________________________________
Completion Certificate Issued: ☐ Yes   Date: __________
RAPIDS Completion Filed: ☐ Yes   Date: __________
Signature: ________________________________________________________________

Credential Issuance Record

Indiana State Board Exam Date: ________________________________
Exam Result: ☐ Pass   ☐ Fail   ☐ Pending
Indiana Barber License #: ________________________________
License Issue Date: ________________________________
Elevate Completion Certificate #: ________________________________
DOL Apprenticeship Certificate: ☐ Filed   ☐ Pending
Barber Rubric OverviewScoring SheetMonthly OJT Evaluation