Work Experience Certification - New Jersey Division of ...

1 State of New JerseyDEPARTMENT OF LAW AND PUBLIC SAFETYDIVISION OF CONSUMER AFFAIRSBOARD OF EXAMINERS OF ELECTRICAL CONTRACTORS124 HALSEY STREET, 6TH FLOOR, BOX 45006 NEWARK, NEW Jersey 07101973-504-6410 work Experience Certification (To be completed by the individual named as a reference.)(Please type or print clearly.)_____Name of applicantName of reference and company name_____Applicant's home addressReference's home or business address_____ Home telephone number (include area code)Reference's telephone number (include area code)_____E-mail addressE-mail above applicant has asked you to certify his or her qualifications (See , Qualifications of Applicants, on thereverse side) to take the examination for an Electrical Contractor's license.

2 Please provide the exact dates of his or her employment. A. From_____/_____/_____to_____/_____/_____ month day year month day year number of hours the applicant worked per explain his or her electrical installation Experience . (Use additional paper if necessary.) you an electrical contractor in any other state or province? Yes NoIf "YES," in what state or province are you a licensee?_____What is your license number?_____If you are a licensed electrical contractor in New Jersey , and you hold a Business Permit, please provide an impression of yourBusiness Permit Seal and please provide your New Jersey license hereby certify that I am the_____of_____Reference/TitleCompanyand that I have personal knowledge of the qualifications of the applicant, and that he or she worked for me for_____ Length of time (years/months)

3 Gaining practical Experience working with tools in the installation, alteration or repair of wiring for electrical light, heat or of 13 Qualifications of for examination for a license as an electrical contractor shall present proof tothe Board that the over the age of 21 years; a high school diploma or equivalency certificate ; had, immediately preceding the submission of the application, at least five years ofhands-on Experience working with tools in the installation, alteration, or repair of wiring forelectric light, heat or power, which work shall have been done in compliance with theNational Electrical Code. Practical hands-on Experience shall not include time spent insupervising, engaging in the practice of engineering, estimating and performing othermanagerial tasks.

4 In the alternative, the applicant may satisfy the practical hands-onexperience requirement by a four-year apprenticeship program approved by both a Federal agencyand a Federally certified State agency and at least one year of practical hands-onexperience as defined in (a)3 above. A certificate of completion issued by theapprenticeship program and a Certification by an employer regarding the additionalyear of practical hands-on Experience shall be submitted with the application forthe electrical contractor s examination; the definition of a qualified journeyman electrician as set forth 13 and completed at least one year of practical hands-on experienceas defined in (a)3 above.

5 The applicant shall submit proof of having satisfied thedefinition of a qualified journeyman electrician in 13 and acertification by an employer regarding the additional year of practical hands-onexperience; a bachelor s degree in electrical engineering and completed two years ofpractical hands-on Experience as defined in (a)3 above. The applicant shall submita copy of his or her diploma and a Certification by an employer regarding theadditional two years of practical hands-on Experience ; in the field of electrical contracting for a least five years immediatelypreceding the date of application. The applicant shall submit a Certification by anemployer establishing that the applicant has at least five years of practical hands-on Experience as defined in (a)3 - 9/11/02