Code of Massachusetts Regulations
105 CMR - DEPARTMENT OF PUBLIC HEALTH
Title 105 CMR 168.000 - Licensure Of Alcohol And Drug Counselors
Section 168.007 - Application to Sit for Oral and Written Examination and Licensing Fees

(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.