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. Note: Per Wis. Stat. § 440.88(4), renewal of certification as a prevention specialist-in-training may be made only twice.
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|