State of Alaska
Department of Community and Economic Development
Division of Occupational Licensing
P.O. Box 110806
Juneau, AK 99811-0806
(907) 465-2589
E-mail: license@dced.state.ak.us
RÉSUMÉ
Describe in detail the applicable years of experience obtained in the category(ies) for which you are applying. The
Certificates in Support must coincide with the experience listed below. Please provide any other information relevant
to category(ies) for which you are applying.
LIST MOST RECENT WORK EXPERIENCE FIRST
LIST WORK EXPERIENCE
EMPLOYER
(IN CATEGORY APPLYING FOR)
Name
Journeyman
Address
Foreman
Supervisor
Contractor
Full-time
Owner/Builder
From
To
Part-time
Other (specify)
___/___/___ ___/___/___
Hours per
Total
week
_______Yr. _______Mo.
________
LIST WORK EXPERIENCE
EMPLOYER
(IN CATEGORY APPLYING FOR)
Name
Journeyman
Address
Foreman
Supervisor
Contractor
Full-time
Owner/Builder
From
To
Part-time
Other (specify)
___/___/___ ___/___/___
Hours per
Total
week
_______Yr. _______Mo.
________
LIST WORK EXPERIENCE
EMPLOYER
(IN CATEGORY APPLYING FOR)
Name
Journeyman
Address
Foreman
Supervisor
Contractor
Full-time
Owner/Builder
From
To
Part-time
Other (specify)
___/___/___ ___/___/___
Hours per
Total
week
_______Yr. _______Mo.
________
08-4033a (Rev. 8/00)
CONTINUED ON REVERSE SIDE