Certification applications must be completed in full and mailed to the appropriate office for processing. Many of the documents are two-sided, in those instances, both sides need to be completed in full.  

A directory of WVMHS&T Offices can be found at the following page:  WVMHST Offices. A list of certified instructors/ trainers may be found at: Certified Instructors.

PRIVACY NOTICE: This privacy notice discloses the privacy practices for the West Virginia Office of Miners’ Health Safety and Training.  This privacy notice applies solely to information collected by this agency.

General Certification Applications

CERTIFICATION CODEFORM
02Apprentice Electrical Certification Application
Apprentice High Voltage Log sheet  
Apprentice Low Medium Log sheet 
Apprentice Electrician Training Program
03Coal Truck Driver Certification Application
06
07
Coal Miner Experience Document
Instructions for Completion of Form
08Shot-firer Application
18Gas Testing Application
20Shaft and Slope Shot-firer Experience Document
21Belt Examiner
26Electrical Certification Application 
28Qualified Diesel Instructor
32Safety Sensitive Personnel Document Form

Foreman & Supervisory Applications

CERTIFICATION CODEFORM
09Underground Mine Foreman Application & Assistant Foreman
Underground Foreman Certification Change Request
Practice Maps
11Surface Mine Foreman Application & Assistant Foreman
Surface Foreman Certification Change Request
15Surface Construction Supervisor Application
14Shaft and Slope Examiner (Foreman) Application
16Clay Mine Foreman Application
19Underground Outby Examiner Application
35, 36Raised Bore / Blind Drilling Superintendent Examiner Foreman and Raised Bore / Blind Drilling Examiner Foreman