Contractor Application  
Is this a New or Existing Application?  
  New Application for Contractor Registration
  Existing Contractor Requesting On-line Access
 
Contractor Name      
Address      
     
     
City      
State     
Zipcode      
Phone Number      
Alternate Phone Number      
Fax Number      
Email Address      
Confirm Email Address     
Alternate Email Address      
 
How would you prefer we notify you?  
  Phone
  Email
 
On-line User ID      
 
On-line User Name      
 
License Type Number Expiration Date Issuing Agency
AGCB       /    /  AL GENERAL CONTRACTORS BOARD  
AHBLB       /    /  AL HOME BUILDERS LICENSE BOARD  
PLUMBING       /    /  AL PLUMBING & GAS BOARD  
HVAC       /    /  AL BOARD OF HEATING & AIR CONDITIONING  
ELECTRICAL      /    /  AL ELECTRICAL CONTRACTORS BOARD  
COUNTYBUS       /    /  BALDWIN COUNTY  
OTHER       /    /   
OTHER       /    /   
OTHER       /    /   
OTHER       /    /