CTIP Form | A&J Training Trust

Certification Training Incentive Program and Class Reimbursement Request Form

Do not wait for certification(s) to post to submit. Submit at the conclusion of training. Submission is due within 60 days of training and/or testing. Approved reimbursement may take up to ninety (90) days from the receipt date of a request.

First Name

Last Name

Local Union

UA Card Number

Phone Number

Address

City

State

Zip Code

Certification Earned for Reimbursement

Date Certification Earned

Type (select one) A & J Class
High Hazard Facility Safety Training Equivalent Completed at OSCA
JCAD 2 Year Program Completion
Large Bore Brazing Certification (BTS 2 and larger) (only certifications earned through practice/or testing at an A&J Training Center qualify)
Natural Trade University Class
Welding Certification (Only certifications earned through practice/or testing at an A&J Training Center qualify)

Security Word

Certification Training Incentive Program and Class Reimbursement Request Form

Do not wait for certification(s) to post to submit. Submit at the conclusion of training. Submission is due within 60 days of training and/or testing. Approved reimbursement may take up to ninety (90) days from the receipt date of a request.

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