Application to Sit for Oral and Written Examination and Licensing Fees
Effective Jan 4, 2008MGL c. 111J, §§ 1 through 8Department of Public Health
- (A) Forms. Application to sit for the examination shall be made on forms provided by the Department.
- (B) Signature. Each application form shall be signed by the applicant.
- (C) Documentation. All education and training claimed must be supported, as appropriate, by an academic transcript or a certificate or letter of completion which includes the applicant’s name; the name of the educational and training institution or provider; the title of the training; the date of completion; and the number of education and training hours associated with completion of the training.
- (D) Evaluations. Each application shall include three evaluations written by individuals with a minimum of six months of direct knowledge of the applicant’s performance. A current, or most recent supervisor shall write one of the three evaluation submitted. Evaluations submitted will be kept confidential, to the extent permitted by law.
- (E) Affidavit of Ethical Principles. Each applicant shall sign an affidavit that states the applicant agrees to abide by the Code of Ethical Principles.
- (F) Fees. Each application submitted shall include the requisite fee of $100.00.