"Application to Register or Renew as a Qualified Electronic Technician in the Northwest Territories" - Northwest Territories, Canada

ADVERTISEMENT
ADVERTISEMENT

Download "Application to Register or Renew as a Qualified Electronic Technician in the Northwest Territories" - Northwest Territories, Canada

Download PDF

Fill PDF online

Rate (4.8 / 5) 16 votes
Page background image
APPLICATION TO REGISTER OR RENEW
AS A
QUALIFIED ELECTRONIC TECHNICIAN
IN THE NORTHWEST TERRITORIES
I apply for registration/renewal as a Qualified Electronic Technician in the NWT.
I understand that electrical permits will NOT be issued to me unless I am registered and
the registration is in good standing.
NAME:
ADDRESS:
TOWN/CITY:
POSTAL CODE:
PHONE:
FAX #:
SIGNATURE:
DATE:
DOB
FOR NEW REGISTRATIONS ONLY:
Please provide a photocopy of a certificate as proof you have had training in the field of
electronics OR provide an affidavit that states you have been employed in this field.
Registration is approved at the discretion of the Chief Electrical Inspector.
FOR RENEWALS ONLY:
My NWT registration number is TX-
Enclose the fee of $79.00 for registration/renewal of 3 years. Cheques or money
orders should be Payable to the GOVERNMENT OF THE NWT. Mail with this
application to:
Electrical/Mechanical Safety
Infrastructure
Government of the NWT
BOX 1320
YELLOWKNIFE NT X1A 2L9
Phone: (867) 767-9043
APPLICATION TO REGISTER OR RENEW
AS A
QUALIFIED ELECTRONIC TECHNICIAN
IN THE NORTHWEST TERRITORIES
I apply for registration/renewal as a Qualified Electronic Technician in the NWT.
I understand that electrical permits will NOT be issued to me unless I am registered and
the registration is in good standing.
NAME:
ADDRESS:
TOWN/CITY:
POSTAL CODE:
PHONE:
FAX #:
SIGNATURE:
DATE:
DOB
FOR NEW REGISTRATIONS ONLY:
Please provide a photocopy of a certificate as proof you have had training in the field of
electronics OR provide an affidavit that states you have been employed in this field.
Registration is approved at the discretion of the Chief Electrical Inspector.
FOR RENEWALS ONLY:
My NWT registration number is TX-
Enclose the fee of $79.00 for registration/renewal of 3 years. Cheques or money
orders should be Payable to the GOVERNMENT OF THE NWT. Mail with this
application to:
Electrical/Mechanical Safety
Infrastructure
Government of the NWT
BOX 1320
YELLOWKNIFE NT X1A 2L9
Phone: (867) 767-9043