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Colorado Division of Fire Prevention and Control
700 Kipling Street, Suite 4100, Lakewood, CO 80215
Main Phone (303) 239-4100
cdps_dfpc_fireworks@state.co.us

APPLICATION FOR DISPLAY OPERATOR CERTIFICATION - LICENSE FEE - $50.00 
APPLICATION FOR PYROTECHNICS OPERATOR CERTIFICATION - LICENSE FEE - $50.00
Application must be filled out completely, and filed AT LEAST 30 DAYS PRIOR to the start of any permitted activities. 
Application Information
Name of individual as you wish it to appear on the license
Please use this format 01/01/2000

Page 2

Fireworks Experience and References
List five (5) fireworks displays in which you actively participated during the last three (3) years for NEW applicants or three (3) displays in the past three (3) years for RENEWALS in good standing. Include contact information for the sponsor or operator of the performance, of whom inquiry can be made as to your character, qualifications and ability to operate a fireworks display.
Fireworks Event 1
Include Contact's street address, city, state, and zip code
Fireworks Event 2
Include street address, city, state, and zip code
Fireworks Event 3
Include street address, city, state, and zip code
Fireworks Event 4
Include street address, city, state, and zip code
Fireworks Event 5
Include street address, city, state, and zip code
Pyrotechnics Experience and References
List five (5) pyrotechnic displays in which you actively participated during the last three (3) years for NEW applicants or three (3) displays in the past three (3) years for RENEWALS in good standing. Include contact information for the sponsor or operator of the performance, of whom inquiry can be made as to your character, qualifications and ability to operate a fireworks display.
Pyrotechnic Event 1
Include Contact's street address, city, state, and zip code
Pyrotechnic Event 2
Include street address, city, state, and zip code
Pyrotechnic Event 3
Include street address, city, state, and zip code
Pyrotechnic Event 4
Include street address, city, state, and zip code
Pyrotechnic Event 5
Include street address, city, state, and zip code

Page 3

Are you presently or have you ever been Licensed or Certified in any other state to operate a fireworks display?
Indicate where you are or have been licensed

Supplemental Information
Have you ever been indicted for, arrested for, cited for or convicted of any crime or juvenile offense before any court? (Do not include minor traffic violations)
(If yes, give date of incident, type of incident and disposition
Has any license of any type held by you been denied, suspended, or revoked for any reason by the state or government agency?
If yes, list each incident of denial, suspension or revocation, the date of the incident, reason for the action and the disposition
General Provision - Fireworks Display Operator
General Provision - Pyrotechnics Display Operator
Required Documentation (scanned documents) to be Submitted with Application
There is a combined attachment limit of 20MB
Colorado Bureau of Investigation Background Check
Please fill in this form, print it, sign it and mail it along with payment of $13 to the address on the top of the form. 
CBI will send us the reply (completed background check).
Fees and Payment 

Acknowledgment:

Under penalties of perjury, by clicking the Submit button below, I certify I am the named applicant above and have carefully read and understand the provisions of Colorado Revised Statutes, Title 12, Article 28, concerning the sale and regulation of fireworks and the Rules and Regulations promulgated there under. This application and the answers given are true and complete to the best of my knowledge.
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