CITC Apprentice Request for Plumbing Affidavits of Experience

I(Required)

am/was a registered CITC Plumbing apprentice. I am requesting affidavit(s) of experience for the following time period:

My WA Plumbing Trainee License number is:

I attest that I have not requested affidavits from my employer for the time period above. I understand that I cannot submit duplicate or overlapping affidavits for the same time periods to L&I Plumbing Licensing, and that while I am an apprentice with CITC, I will not and cannot request Plumbing affidavits of experience from my employers.

From

Please:

mail the affidavit(s) to my home address on file

call me to pick up the affidavit(s) at the CITC main office in Bellevue

Signed: