MN Electrical Worker Experience Form
Please Print Clearly
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Do you have work experience in the Electrical Industry? (if "Yes," you must provide proof of work experience)
Yes
No
If "Yes" How many Years' Experience?
1-3 Years
3-5 Years
5-10 Years
10-20 Years
20+ Years
Please list your previous/current employer(s)
Do you have a MN State Journeyman's License (or Master's License)?
Yes
No
What is your license(s) Number?
Do you have a valid MN Driver's License?
Yes
No
Do you have reliable transportation?
Yes
No
Do you have OSHA 10 Safety Training?
Yes
No
Do you have NFPA-70E training?
Yes
No
All Information provided will be kept confidential
Back
Next
Please Complete Experience Assessment Below
Check the respective box next to each discipline.
Rigid & IMC Conduit Bending, Threading and Installation
Rows
No Exp
Some Exp
Very Exp
1/2" through 1"
1 1/4" through 2"
2 1/4" through 4"
Explosion Proof Work
PVC Conduit
EMT (Electrical Metallic Tubing) Bending and Installation
Rows
No Exp
Some Exp
Very Exp
1/2" through 1 1/4"
1 1/2" and up
Wire Pulling and Terminating
Rows
No Exp
Some Exp
Very Exp
#16 through #2
#1 through 500MCM
Voice Data, Video
Fiber Optic
NEC Knowledge
Rows
No Exp
Some Exp
Very Exp
Art 110 Electrical Installation
Art 200 Grounded Conductors
Art 210 Branch Circuits
Art 230 Services
Art 240 Overcurrent Protection
Art 250 Grounding and Bonding
Art 300 Wiring Methods
Art 310 Conductors
Transformer Wiring
Rows
No Exp
Some Exp
Very Exp
Control Transformers
Power Transformers
Service and Electrical System Installations
Rows
No Exp
Some Exp
Very Exp
1 Phase Service Installation
1 Phase general system wiring
3 Phase Service Istallation
3 Phase general System wiring
Type of Experience
Rows
No Exp
Some Exp
Very Exp
Residential
Commercial
Industrial
Residential Service
Commercial Service
Renewable/Solar
Any further information you'd like us to know about your electrical experience?
All information provided will be kept confidential
Submit
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