New Licensed Employee Application Check Off Sheet

1. You have reviewed the filing instructions and legal requirements for the type of license, approval or qualification that you are seeking.

2. Licensed Employee

3. You have included all required attachments listed in this form.

4. The Applicant’s Request to Release Information & Affirmation and Consent forms is notarized.

5. Every question has been answered truthfully and in its entirety.

6. You retain a completed copy of your application package for your own records.

7. Include a copy of completed application in approved electronic format.

8. Employee Application fee of $250.

9. $49.00 Background investigation fee