2021 Mine Contractors Exam

Application Instructions

Please provide all required information on each page of the application. Please provide sufficient detail as work history to demonstrate that you are qualified for the exam and certification.

Applicant’s Requirements

The Applicant Must have a minimum of 2 years work experience in the work that your Company performs to qualify for this certification.

Applicant’s Certification

I hereby certify under penalty of perjury, and subject to the provisions of W.S.§ 6-5- 303 and its penalties, that I have not knowingly submitted false or misleading information to the Wyoming State Mine Inspector on this Contractor Certified Person Application, and certify that I meet the qualifications for certification.

Mine Contractors Exam Application

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Please enter your birthday and the last 4 digits of your Social Security Number

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Last 4 Digits of SSN
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Please verify your information, accecpt the terms, then create a 4 digit Pin number

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Address

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Birthdate
SSN Last 4
Certification

I hereby certify under penalty of perjury, and subject to the provisions of W.S. § 6-5-303 and its penalties, that I will not knowingly submit false or misleading information to the Wyoming State Mine Inspector on this Mine Examiner & Contractors Certification Application, and certify that I meet the qualifications for certification in the type of mining applied for as stated in W.S. § 30-2-309 of the Mines and Minerals Statues of the State of Wyoming.

Agreement
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