Trades License & Examination Application

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CITY OF READING, PENNSYLVANIA
LICENSE & EXAMINATION APPLICATION FORM

 

COMPLETE THIS FORM (PRINT IN INK OR TYPE ) ATTACH ANY PERTINENT QUALIFICATION DATE RELATED TO THIS EXAMINATION FOR REVIEW BY THE BOARD OF EXAMINERS.

 

NAME:          _________________________________

DATE OF BIRTH:   _________________________________

ADDRESS:       _________________________________

ZIP CODE:                _________________________________

CITY/TOWN:   _________________________________

STATE:                     _________________________________

AREA CODE:________ PHONE #:_________________

SOCIAL SECURITY:_________________________________

 

FOR WHICH LICENSE ARE YOU APPLYING?                                           RECIPROCAL LICENSE

 

MASTER PLUMBER

MASTER ELECTRICIAN

MECHANICAL CONTRACTOR

JOURNEYMAN PLUMBER

JOURNEYMAN ELECTRICIAN

MECHANICAL JOURNEYMAN

ACP PLUMBER

AIE ELECTRICIAN

SPRINKLER CONTRACTOR

AIP PLUMBER

 

SPRINKLER INSTALLER

 

EMPLOYER:                                                                                      FROM:                                                    TO:

 

ADDRESS:                                                                                         LICENSE # OF MASTER/CONTRACTOR:

                                                                                  NAME OF MASTER:

 

PHONE NUMBER:

 

EMPLOYER:                                                                                      FROM:                                                   TO:

 

ADDRESS:                                                                                         LICENSE # OF MASTER/CONTRACTOR:

                                                                                  NAME OF MASTER:

 

PHONE NUMBER:

 

EMPLOYER:                                                                                      FROM:                                                  TO:

 

ADDRESS:                                                                                         LICENSE # OF MASTER/CONTRACTOR:

                                                                                  NAME OF MASTER:

 

PHONE NUMBER:

 

     

 

HAVE YOU BEEN TESTED PRIOR TO THIS APPLICATION?        YES                                NO                          
DATE AND PLACE                                                                                            

 

DO YOU CURRENTLY HOLD ANY ABOVE LICENSE IN A FIRST, SECOND, OR THIRD CLASS CITY?

YES                                                              NO                      

 

IF YES, SPECIFY THE TYPE OF LICENSE:                                                                                                                                   
PLACE OF ISSUANCE:                                                       DATE OFF ISSUANCE:   _________________________

 

NOTE: ALL APPLICATIONS FOR EXAMINATION MUST BE RECEIVED BY THE CODES OFFICE AT LEAST  THIRTY (30) DAYS PRIOR TO THE TEST DATE.  APPLICATION FEE RECEIPT MUST BE PRESENTED AT APPLICANT SCREENING.  PHOTO IDENTIFICATION REQUIRED AT TEST SITE. ANY FRAUDULENT INFORMATION FOUND IN APPLICATION WILL VOID THE ENTIRE APPLICATION.  ALL EXAMINATION FEES ARE NON REFUNDABLE.

 

AFFIDAVIT/SUBSCRIBED AND SWORN BEFORE ME THIS _______ DAY OF ______________20_________
SIGNATURE IN INK OF PERSON ADMINISTERING OATH:___________________________________________________
MY COMMISSION EXPIRES:____________________________ MUNICIPALITY:_________________________________
COUNTY:_____________________________________

APPLICANT SIGNATURE IN INK______________________________________________________________