INSTRUCTOR
Instructor Name
Address
City
State
ZIP Code
Telephone Number
SPONSOR
Sponsored by
Contact Person
Telephone Number
Course Title
Instructor Qualifications:
Instructor MUST have at least one of the following qualifications. Check all that apply.
Submit documentation to validate qualifications (i.e. training certificate, proof of licensure, etc.)
A resume will not suffice.
A Master Electrician with at Least One Year’s Experience in Electrical Inspection.
A Journeyman or Master Electrician who is Certified as an Instructor through a Vocational Education
Department.
A Person with a Valid Teaching Accreditation from a Trade or Technical School, College, or University Teaching
Electrical Curriculum.
Registered or Licensed Electrical Engineer with at Least Four Years’ Experience in Design of Premise Electrical
Wiring Systems.
A Representative from NFPA, Testing Laboratories, IAEI, and Other Product Manufacturer Representatives with
Five YearsPractical Experience in the Subject Taught.
Instructor of an Apprenticeship Training Program. (Limited Basis Only)
Date
FOR OFFICE USE ONLY
Unlimited Limited
Comments
Instructor Number
Not Accepted
Comments
Date
Submit completed application to:
North Dakota State Electrical Board Phone: 701-328-9522
PO Box 7335 Fax: 701-328-9524
Bismarck, ND 58507 Email address: electric@nd.gov
Website: www.ndseb.com
CONTINUING EDUCATION
INSTRUCTOR APPLICATION
NORTH DAKOTA STATE ELECTRICAL BOARD
SFN 53255 (12-2020)