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Wisconsin Department of Safety and Professional Services Trades Credentialing Unit PO Box 78780 Milwaukee, WI 53293-0780 Phone: 608-266-2112 Email: DspsSbCredentialing@wi.gov Web: http://dsps.wi.gov Scott Walker, Governor Dave Ross, Secretary JOURNEYMAN ELECTRICIAN LICENSE Your application will not be processed or will be delayed unless you: [ ] 1. Complete the application including signing and dating the first page. [ ] 2. Write in your social security number. [ ] 3. Attach the specified documents listed on this application. [ ] 4. Attach the specified fee listed on this application. [ ] 5. Make a photocopy of the completed application for your records. By signing below, the applicant swears that all information provided on this application is true, accurate and that the credential requirements are met. Notice: Information collected may be used for participation surveys, eligibility for approvals, law enforcement (including child support and tax delinquency enforcement) purposes and other secondary purposes. The department may also provide this information to requesters pursuant to Wisconsin s open records law, ss. 19.31-19.39 stats. Social security numbers are required when applying for a license per Wisconsin Stats, but they may not be disclosed to anyone except other State of Wisconsin governmental agencies. Applicant Information Applicant s Social Security No: Applicant s Name (First, Middle and Last): Address No. & Street, or P.O. Box: City, Town or Village, State, Zip + 4 Code: Country, If Other Than United States: Telephone No. (include area code): If Available, Fax No. (include area code): If Available, E-mail Address: Applicant s Signature Date (mo/day/yr) Send application and payment to: DSPS Trades Credentialing, PO Box 78780, Milwaukee, WI 53293-0780. Office location: DSPS Trades Credentialing, 1400 East Washington Ave., Madison, WI 53703 All other correspondence: DSPS Trades Credentialing, PO Box 7082, Madison, WI 53707 Phone: 608-266-2112. TTY: Contact through Relay or DspsSbCredentialing@wi.gov. COST CODE 7631 Reason for Credential: Except as provided under s. 101.862 (4), Stats., no person as of April 1, 2013 may install, repair or maintain electrical wiring unless the person holds a license or registration issued by the department as a licensed master electrician, licensed residential master electrician, licensed journeyman electrician, licensed industrial journeyman electrician, licensed residential journeyman electrician, registered beginning electrician, registered electrical apprentice, registered industrial electrical apprentice or a registered residential electrical apprentice. A person holding a journeyman electrician license may apply without examination for a UDC-electrical inspector certification. Requirements of Credential: A person who holds a license as a licensed journeyman electrician shall perform electrical wiring activities under the general supervision of a person who holds a license as a licensed master electrician or may perform electrical wiring activities under the general supervision of a person who holds a license as a licensed residential master electrician provided the wiring is associated with dwellings, dwelling units and detached accessory buildings and structures serving the dwellings SBD-10220 (R 3/13)

or the dwelling units, such as garages, carports, gazebos and swimming pools. Education Hours Required to Renew: The renewal of a journeyman electrician license, with an expiration date after June 30, 2007, shall be contingent upon the person obtaining at least 24 hours of acceptable continuing education by March 30th of the year their credential expires. A person who holds a credential as a certified journeyman electrician may apply to the department for waiver of the continuing education requirements on the grounds of prolonged illness or disability or similar circumstances. Each application for waiver shall be considered individually on its merits by the department. A person who initially obtained his or her journeyman electrician license by completing an electrical apprenticeship and whose request to renew his or her certification is denied because of the failure to fulfill the continuing education requirements shall be required to take and pass the certification examination in order to reacquire the journeyman electrician license. If you pass the exam to obtain this credential, you will not be required to take any continuing education prior to your first expiration date. You will be required to fulfill the continuing education requirements starting after you have renewed your credential for the first time. If you obtain this credential by any other method, you will be required to fulfill the continuing education requirements at least 3 months prior to your expiration date. Applying for Journeyman Electrician Credential A person may obtain a credential as a certified journeyman electrician by either one of the following: Method 1 Method 2 Completing the necessary hours of experience and taking and passing the journeyman electrician license examination. Submitting evidence of completing an electrical construction apprenticeship program and the program has been recognized by the department under ch. 106, Stats., and the federal department of labor. * WI apprentices only: All Construction Electrician apprentices who wish to complete their apprenticeship after Dec. 31, 2011 are required to pass the Journeyman exam before their apprenticeship will be completed. You must contact the Bureau of Apprenticeships to obtain a letter stating you are eligible to take the exam. Attach this letter and apply under method 1. Are you a Veteran? If yes, please answer the following questions to see if you qualify for a fee waiver or equivalency for this credential. 1. Are you requesting a waiver of your initial credentialing fee under method 1? Yes Provide a copy of your Department of Veterans Affairs voucher code. DVA Voucher Code: Your application fee of $35 will be waived now and your credential fee will be waived once you pass the exam. You must submit $30 for the exam fee at this time. No Submit the fee of $65. 2. Are you requesting a waiver of your initial credentialing fee under method 2? Yes Provide a copy of your Department of Veterans Affairs voucher code. No Submit the fees listed in the table below. 3. Are you requesting equivalency of your military training and experience? DVA Voucher Code: Yes Provide copies of your service school academic reports, certificates of training, or training documentation signed by your unit s training NCO or any other relevant experience that would satisfy the requirements of method 1 or 2. You may attach a personal narrative to further explain why your education / training / experience in the military has helped you prepare for this profession. No Complete the requirements under method 1 or 2. You may contact DVA at 1-800-WisVets or www.wisvets.com for assistance in obtaining your DVA Voucher Code and/or documents related to your training and experience. Method 1 - Hours of Experience and Examination Application and Exam Fee (nonrefundable): $ class code 7631 Make checks payable to: State of WI DSPS. The fee consists of a $35 application fee and an exam fee of $30. When the exam is passed, the applicant will be asked to pay a $100 credential fee which will be prorated because the credential expires on a specific date. The credential, which will be issued after the exam is passed and the prorated credential fee paid, will be effective for four years from June 30 th.

Qualifications for Examination: A person applying for a journeyman electrician license examination shall have at least 1,000 hours per year of experience for at least 5 years in electrical construction work. If a person has successfully completed semesters in a school of electrical engineering or other accredited college, university, technical or vocational school in an electrical-related program, the applicant may claim 500 hours of experience for each semester up to a total of 2,000 hours and 2 years toward the required experience. * All Construction Electrician apprentices who wish to complete their apprenticeship after Dec. 31, 2011 are required to pass the Journeyman exam before their apprenticeship will be completed. You must contact the Bureau of Apprenticeships to obtain a letter stating you are eligible to take the exam. Attach this letter and select the date below. The time period does not have to be consecutive years from one row to the next. In the Time Period column fill in the beginning month and year and the ending month and year in which the experience hours were completed. In the Experience Hours column fill in the number of hours claimed for that time period but do not record more than 1000 hours in the column even if you worked more than 1000 hours. If the hours were witnessed by more than one person, the hours witnessed by each person must be filled in on separate rows. Photocopies of this page may be made if you need additional room or would like to mail to witnesses to sign. The witness must have observed or had knowledge of the number for work hours performed in electrical construction. Electrical construction means the installation of electrical wiring. Electrical construction does not include the maintenance, repair or fabrication of electrical equipment or the installation of electrical wiring and equipment covered by ch. PSC 114. Began Time Period Ended Experience Hours Hours Witnessed by (please print or type) Signature of Witness Telephone Number of Witness For each semester in a school of electrical engineering or an electrical-related program, specify the beginning and ending date of the semester, record 500 hours of experience, write the name of the school, and Attach a copy of the official transcripts from the school to this form. No experience hours should be recorded if official transcripts are unavailable. This must be full-time schooling, not part time or evening classes. Began Time Period Ended Experience Hours Name of School In order to obtain the credential the applicant must obtain a score of at least 70% on an examination. The exam will cover information contained in SPS 305 and SPS 316, Wisconsin Administrative Code and the 2008 National Electrical Code. The exam is open book. Copies of current Wisconsin Administrative Codes may be obtained from Document Sales, 608-266-3358 or 800-362-7253. Copies of current National Electrical Codes may be purchased from the National Fire Protection Association, 800-344-3555. When there is a change to Wisconsin Administrative Codes, exams will cover the new code one month after the effective date. ***NOTE - Exams will cover the 2011 National Electrical Code beginning in March 2014. *** To schedule an upcoming exam: Indicate FIRST CHOICE (1) and SECOND CHOICE (2) in the event one exam site is full. Submit the fee and this application to the division at least 30 days in advance of the exam date chosen. Keep a copy of this application for your records. You may only schedule one future exam session at a time for each credential type. Applications sent in for multiple exam sites / times will be denied and a refund will not be issued. You will receive a letter from DSPS confirming your upcoming exam. Please check this form over carefully upon receipt so that you know when/where to take your exam.

If you need special accommodations, please contact us at DSPSSBCredentialing@wi.gov Select one*: AM (Starts at 8 a.m.) or PM (Starts at 1 p.m.) *some plumbing exams have 2 parts so you will be scheduled for both the AM and the PM session when taking both parts Pewaukee WCTC Education Center, 800 Main St, Pewaukee, WI 53072 2013 October 15 November 19 December 18 2014 January 8 February 12 March 12 April 9 May 14 June 11 July 9 August 13 September 10 October 8 November 12 December 10 Eau Claire The Plaza Hotel & Suites, 1202 W Claremont Ave, Eau Claire, WI 54701 2013 December 3 2014 February 26 April 23 June 25 August 27 October 22 Appleton Fox Valley Technical College, 1825 North Bluemound Dr, Appleton 54914 2013 November 5 2014 January 22 March 27 May 28 July 23 September 24 November 25 Method 2 - Completing an Electrical Apprenticeship * All Construction Electrician apprentices who wish to complete their apprenticeship after Dec. 31, 2011 are required to pass the Journeyman exam before their apprenticeship will be completed. You must contact the Bureau of Apprenticeships to obtain a letter stating you are eligible to take the exam. Attach this letter and apply under method 1. The fee for applying for the credential using method 2 is as specified in the following table: Month Application Fee Month Application Fee Month Application Fee January $122.52 May $114.20 September $130.84 February $120.44 June $112.12 October $128.76 March $118.36 July $135.00 November $126.68 April $116.28 August $132.92 December $124.60 Record the amount of the fee you will be sending in the box below: Fee Submitted (nonrefundable): $ class code 7631 Make checks payable to: State of WI DSPS. The credential will be effective for four years from June 30 th. Attach to this form a photocopy of the Certificate of Apprenticeship or a letter from the Wisconsin Bureau of Apprenticeship Standards stating that you have completed an electrical construction apprenticeship program and the program has been recognized by the department under ch. 106, Stats., and the federal department of labor. If you have questions regarding the Certificate of Apprenticeship or letter, call or write to one of the following Bureau of Apprenticeship Standards offices: Telephone Address (Please address to Bureau of Apprenticeship Standards Office) (920) 832-5303 Fox Valley Technical College 1825 N Bluemound Dr, Appleton, WI 54912-2277 PO Box 2277 (715) 738-3853 Chippewa Valley Technical College 770 Scheider Rd, Chippewa Falls, WI 54729 (920) 693-1102 Lakeshore Technical College 1290 North Avenue Cleveland, WI 53015-1414 (920) 492-5618 Northeast Wisconsin Technical PO Box 19042 Green Bay, WI 54307-9042 College, (262) 564-3210 Gateway Technical College 3520 30 th Avenue Kenosha, WI 53144-1690 (608) 785-9176 Western Technical College 402 North Eighth Street La Crosse, WI 54601 (608) 246-3887 & Madison Area Technical College 2125 Commercial Avenue Madison, WI 53704 (608) 246-7900 (414) 227-4973 State Office Building 819 North 6th St, Milwaukee, WI 53203 Room 850 (414) 768-7190 Milwaukee Area Technical College 6665 S Howell Avenue Oak Creek, WI 53154 (MATC) South Campus (262) 695-7778 Pewaukee Workforce Dev. Center 892 Main Street, Pewaukee, WI 53072 Suite J (715) 261-8754 Workforce Development Center 364 Grand Avenue Wausau, WI 54403

Telephone Address (Please address to Bureau of Apprenticeship Standards Office) (262) 335-5849 Moraine Park Technical College 2151 N Main Street West Bend, WI 53090