Online Fireworks Application

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Last Name of Applicant:
First Name of Applicant:
Middle Initial of Applicant:
U.S. Citizen?
Why Submit Proof of Citizenship?   Proof of Citizenship:   Examples
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:        
Password:  
Confirm Password:     
Password Question:
Answer:  
   
Password must be at least:
-8 character minimum
  -12 character maximum
  -1 uppercase
-1 lowercase
-1 number
 
 
 
"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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