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Electrician's License Application

  1. Over the age of 18?*

  2. The Electrical Commission may conduct a background check of all applications for licensing. Persons may be asked to supply information in addition to that requested in this application before the applicant is approved to take the examination.

  3. If you have lived at your present address for less than 10 years, please provide us with your residences for the past 10 years.

  4. Were you ever refused a fidelity bond?*

  5. Have you ever refused a fidelity bond?*

  6. Have you ever been employed by State or Federal employer for security reasons?*

  7. Have you ever been discharged or asked not to complete an electrical project?*

  8. Have you ever had a license with this City?*

  9. Have you previously applied for an electrical license with this City?*

  10. Do you have, or have you ever had, relatives licensed by this City?*

  11. Do you possess any special licenses of a skill, trade or craft?*

  12. Have you participated in any electrical apprenticeship programs?*

  13. Do you possess a valid driver's license?*

  14. Are you a journeyman electrician?*

  15. Provide the electric utility companies whose service area you have worked in, including the utility representatives name, address and telephone numbers, who are familiar with your electrical installations.

  16. Provide the City/Municipality where you have worked, including the name, addresses, and telephone number of the City, County or State Electrical Inspector who are familiar with your electrical installations.

  17. Have you ever had an electrical license revoked?*

  18. EDUCATION

  19. UNITED STATES MILITARY EXPERIENCE

  20. BEGIN WITH LAST EMPLOYER, LIST ELECTRICAL EXPERIENCE

  21. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  23. This field is not part of the form submission.