Suffolk County 8 Hour Master Electrician Renewal September 20, 2025 (In Person Class)

Suffolk County 8 Hour Master Electrician Renewal September 20, 2025

In Person Class
Please fill out info below and e-sign. Then Click Submit.
Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Address*

Business Name

Street

CityState / Province

Postal / Zip Code
Website
Picture of Front Drivers License*

Browse Files
Please take a clear picture from your Cell Phone and upload Cancelof
Picture of Front Suffolk License*

Browse Files
Please take a clear picture from your Cell Phone and upload Cancelof
Contact Person*
Telephone Number*

Area CodePhone Number
Cellular Number*

Area CodePhone Number
Email:*
example@example.com
Please select who is providing payment for class*
*If you are the business owner please select Self
Date of Birth*

MonthDayYear
Enter your date of Birth

My Products

(In Person Class) September 20, 2025 Saturday 8am to 5pm 65 Elm Street, Copiague, NY 11726$150.00

Total $0.00

Credit Card

Apple Pay

Google Pay

Date*

MonthDayYear
Date
Signature*

Clear
By clicking "Preview PDF", you can preview the PDF of the Exempt Program Disclosure Form. Once you have read the form in full, please click submit to finalize your enrollment.
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