Alabama Fire Marshal's Office

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* Select One:
Renewal
Initial

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* Select Class:
Select Certification Class UNLIMITED GENERAL ABOVE GROUND GENERAL UNDER GROUND DEMOLITION SPECIAL Required
* First Name:
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* Last Name:
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* Race:
Race Caucasian African American Hispanic Asian Pacific Islander Native American Alaskan Native Other Required
* Gender:
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* Date of Birth:
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* Email Address:
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* Mailing Address:
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* City:
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* State:
State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA CANADA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING Required
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* Employer:
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* Employer Address:
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* City:
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* State:
State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA CANADA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING Required
* Zip:
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* Employer Phone:
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* 1) Have you ever been certified or licensed by this office before?
Yes
No Required
* 2) Are you currently certifed and licensed in any other state?
Yes
No Required

* 3) Have you ever been denied a blaster's license in any state?
Yes
No Required

* 4) Has this blaster ever been charged with or convicted of a crime involving the illegal use of explosives?
Yes
No Required

* 5) Are you under indictment or information for, or have you been convicted in any court of, a crime punishable by imprisonment for a term exeeding one year or a felony? Charges may include, but are not limited to, crimes involving drugs, burglary, robbery, murder, manslaughter, and explosives or firearms violations.
Yes
No Required

* 6) Are you a fugitive from justice?
Yes
No Required

* 7) Are you an unlawful user or addicted to the use of alcohol, narcotics or dangerous drugs?
Yes
No Required

* 8) Have you ever been adjudicated mentally defective or committed to a mental institution?
Yes
No Required

* 9) Are you a U.S. Citizen?
Yes
No Required

* 10) Have you been discharged from the armed forces under dishonorable conditions?
Yes
No Required

* 11) Have you ever renounced your U.S. Citizenship?
Yes
No Required

* 12) Do you store explosives?
Always
Occasionally
Never Required


I hereby certify that the information provided herein is true and correct.