Online Fireworks Application

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Urgent! Please verify and update email address before submitting an application. Permits will be sent to the email provided below. If email address is up to date, click the Submit Application link above.
Last Name of Applicant:
First Name of Applicant:
Middle Initial of Applicant:
U.S. Citizen?   
  Proof of Citizenship:   Examples        Why Submit Proof of Citizenship?
Social Security Number:  (XXX-XX-XXXX)
Date of Birth:  (MM/DD/YYYY)
Home Telephone Number:
Work Telephone Number:
Mailing Address:  
    City, State, Zip Code:        
Email Address:        
Confirm Email Address:    
Confirm Password:      
Password Question:
Password must be at least:
-8 character minimum
-12 character maximum
  -1 uppercase
-1 lowercase
-1 number
For additional security, please check the checkbox below (and complete any puzzle prompts you may receive).
"Section 30 of the Immigration Act defines professional licensure to be a business transaction, and requires an applicant for professional licensure, who is US citizen, to demonstrate citizenship by presenting at least one of the documents named in the Code of Alabama 1975 Section 31-13-29(g)."

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