Minnesota Department of Labor and Industry

Construction Codes and Licensing Division

Education, Rules and Code Development
443 Lafayette Road N., St. Paul, MN 55155-4341
Phone: (651) 284-5012 Fax: (651) 284-5749
www.doli.state.mn.us TTY: (651) 297-4198

2008 Schedule Of Exam Locations and Instructions

General Information

This form is to be completed and returned to the Department of Labor and Industry after all
necessary prerequisites have been met. Please review the following information regarding
the selection of exam locations.

Š The Building Codes and Standards Unit will conduct examinations for the following
certification categories: Certified Building Official, Certified Building Official – Limited, and
Accessibility Specialist.
Š Complete the application form on the other side. Please return the completed information
as soon as possible. Applications are accepted on a first come, first served basis.
Š The exam locations and dates provided below are subject to change if an insufficient
number of applications are received.
Š Applicants will receive written confirmation of the exact exam date and location. Written
confirmations will be mailed a minimum of seven to ten days prior to the scheduled
exam date. Exams start at 9:00 AM at most locations and 9:30 AM in St. Paul unless
noted otherwise below.
Š Portions of the following requested information are private. It may be released to you or
State agencies pertaining to the exam and/or to verify your certification classification.
Your Social Security number is requested to distinguish you from other applicants and
make processing more efficient. If it is not provided, we will need to assign an individual
identification number to ensure that your records will not be confused with those of other
applicants. You will need to use that assigned number when contacting the Department of
Labor and Industry concerning any of your records. Name, address and home phone
number are required to distinguish you from other applicants, and to enable us to contact
you. (M.S. 13.04 Subdivision 2)

Test Site Locations and Dates Available

St. Paul Detroit Lakes Grand Rapids Mankato

January 18 (7:00) * * February 7 February 21 January 24
March 22 April 10 April 24 March 20
May 17 June 19 June 26 May 22
July 19 August 14 August 21 July 24
August 30 October 9 October 23 September 25
October 18 December 4 December 18 November 20
November 15
* * Examination during Annual Building Official Institute at the Earl Brown Continuing Education Center

EC004 09-07
Minnesota Department of Labor and Industry
Construction Codes and Licensing Division
Education, Rules and Code Development
443 Lafayette Road N., St. Paul, MN 55155-4341
Phone: (651) 284-5012 Fax: (651) 284-5749
www.doli.state.mn.us TTY: (651) 297-4198

Applicant information
Please print clearly

Last Name First Name MI Social Security Number

-- --

Street Address City State ZIP

Work Phone Home Phone E-mail Address

( ) - ( ) -

CERTIFICATION CATEGORIES

FOR OFFICE USE ONLY

CHECK ONLY ONE BOX
CERTIFIED BUILDING OFFICIAL
CERTIFIED BUILDING OFFICIAL – LIMITED
ACCESSIBILITY SPECIALIST

Request For Exam Site Location

Location Date
First Choice: __________________ __________________

Second Choice: __________________ __________________

Third Choice: __________________ __________________

EC004 09-07