2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record. To apply for a predetermination, please fill out
Form #3085 and submit all required documentation specified on the form. Pursuant to
Wis. Stat. §
111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.
Wis. Stat. § 440.08 (2), the required renewal date for the Prevention Specialist In Training credential is 02/28/odd years. Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.
2017 Wisconsin Act 262, as of May 1, 2018, the requirements to obtain a Prevention Specialist in-training credential have changed.
Must complete 40 hours of approved education, including five (5) hours specific to ethics in the following content areas:
- Planning and evaluation
- Prevention education and service delivery
- Community organization
- Public policy and environmental change
- Professional growth and responsibility
Application for Licensure
2745||Application for Prevention Specialist In Training |
2781||Education and Training Form |
||Malpractice Suits or Claims Form (if applicable)|
3085||Application for Predetermination|
2252||Convictions and Pending Charges|
||Fax Payment Form|