Arkansas Department of Health

Please provide the below information to request a
Paper Based Exam:

Registration:	Water Operator License Exam Select <-START HERE
Name:	First:  Middle:  Last:
Address 1:
Address 2:
City, State, Zip	, ,
Water System/City:
Training ID:	(Last 4 digits of SSN & 1st 3 letters of your last name. Example: 1234XYZ)
Email:
Verify Email:
Office Phone:
Cell Phone:
Fax:
License Application or Re-Exam Fee: Open link for application	Has been paid    Will be submitted within 5 days
Mandatory Training Requirements: Open link for requirements	Has been met    Will be met by exam session

I agree – That this obligates the above exam applicant to the below requirements:
·         If this is first time taking the above requested exam, a license application and $35.00 fee is required.
·         If this exam registration is to repeat the above requested exam, a $25.00 fee is required.  Please use the re-exam fee, billing invoice provided with your previous exam results to submit the fee.
·         If this is first time taking the above requested exam, attendance of all mandatory training requirements must be documented as met prior to taking the exam.  Please submit copies of attendance certificates immediately, or if attendance of course is scheduled, please provide schedule.

 
Selecting the submit button obligates the above exam applicant to the above required licensing fees and training documentation.