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Substance Abuse Counselor in Training - Application Forms


Application Forms
Form # Title/Description
2743 Application for Substance Abuse Counselor In-Training 
3079Certificate of Completion of Dept. Approved Comprehensive Substance Abuse Education Program (360 Hour Program) For applicants who have completed a Department approved 360 hour program
3080Certificate of Completion of Educational Field Experience In Substance Abuse Disorder Treatment For applicants who have completed an organized educational field experience
2832 Education and Training Form For applicants who have completed 100 hours of specialized education 
2770 Employment Verification Form 
2252Convictions and Pending Charges
2829Malpractice Suits or Claims Form (If applicable)  
3071 Fax Payment Form 

Other Information/Forms


Substance Abuse Counselor in Training - Certification Information