Application for Upgrade of Fireworks Operator Certificate
Printable version – (PDF, 57 kb)
Please PRINT Clearly - Applicant fills out Sections A and B. Do not fill out Section C.
A. APPLICANT INFORMATION
Family Name ____________________________________________
Given Name ____________________________________________
Date of Birth (yyyy/mm/dd) ______________
Mailing Address _________________________________________________
City ____________________
Province/Territory ___________________________
Postal Code ___________
Telephone ________________
Fax _________________________________
E-Mail _______________________
Organization (if related to fireworks or pyrotechnics) _____________________________
Signature of Applicant ___________________________________
Current Certificate Type / Certificate Number /Certificate Number Expiry Date – Check box for existing Fireworks Operator certificates
- □ Display Fireworks – Display Assistant D __________
- □ Display Fireworks – Display Supervisor D __________
- □ Display Fireworks – Display Supervisor - endorsements D __________
- □ Pyrotechnics Special Effects – Pyrotechnician P __________
- □ Pyrotechnics Special Effects – Senior Pyrotechnician P __________
B. UPGRADE REQUESTED
Requested Certificate Type – Check box for requested Fireworks Operator certificate and specific endorsement if applicable
□ Display Fireworks – Display Supervisor
- Applicant has acted as a Display Assistant in at least three fireworks displays within five (5) years after the day on which the applicant completed the display fireworks safety and legal awareness course.
□ Display Fireworks – Display Supervisor with endorsements
-
Applicant has met the current certification requirements for the requested endorsement. The applicant may apply for more than one endorsement in an application.
- □ Large Shells
- □ Rooftop, Bridge and Flatbed Firing Sites
- □ Nautical Effects
- □ Floating Platform Firing Sites
- □ Flying Saucers
□ Pyrotechnics Special Effects – Senior Pyrotechnician
- Applicant has acted as a Pyrotechnician for at least two years and must submit a resume which includes a letter from a supervisor (Senior Pyrotechnician or Special Effects Pyrotechnician) attesting that the applicant can safely use all authorized fireworks articles and powders.
□ Pyrotechnics Special Effects – Special Effects Pyrotechnician
- Applicant has acted as a Senior Pyrotechnician for at least two years and must submit a resume which includes a letter from a supervisor (Senior Pyrotechnician or Special Effects Pyrotechnician)attesting that the applicant can safely use all authorized fireworks articles and powders and special purpose pyrotechnics.
To apply for the upgrade, mail the required information, photos and payment to your ERD regional office.
- Form F17-02 completed and signed;
- Copy of your work journal, including letters of recommendations as required;
-
One (1) photo taken within the last 12 months. Digital photos are acceptable. Once you have returned by mail your application and
payment, you may email the digital file with your last name as the file name. (i.e., Smith.jpg) to the email address in your region with your name and certificate number in the subject line; and - Payment of $100.00 – certified cheque or money order payable to Receiver General for Canada.
Canada: (excluding Quebec)
580 Booth Street, Ottawa (ON) K1A 0E4
Tel. (613) 948-5200, Fax. (613) 948-5195, Email: canmet-erd@nrcan.gc.ca
Quebec:
P.O. Box 100, 2050 Girouard West, Saint-Hyacinthe (QC) J2S 7B2
Tel. (450) 773-3431, Fax. (450) 773-6226, Email: EasternRegion@nrcan.gc.ca
C. ERD APPROVALS (for office use only)
FINANCE
Cheque or Money Order No.________ Fee Paid: $ ________ Reference no.____________