Request Date: 

-- mm/dd/yy

Please provide all information:

First Name
Last Name
Employer
License No.
Address
Address (cont)
City
State
Zip
Phone
Email

Affidavit requested for:

  Trainee Card renewal
  Work Alone Card
  Journeyman Test Qualification

Comments?:

Apprentice Verification Code*: 

*This verification code is required in order for your request to be processed. 

If you do not yet have a code, please contact the IEC of Washington administrative office to establish one.  This code is unique to you and must consist of 8 - 15 characters including numbers, letters or any symbol located on the number keys of a standard keyboard excluding parenthesis ( ! @ # $ % ^ & * ).

By submitting this form, you are agreeing to receive communication from IEC of Washington via the email address you have provided herein.