Get Lpca Reinstatement Form Ky

Filling out the Lpca Reinstatement Form Ky is a necessary process for individuals seeking to reinstate their licensed professional counselor associate credential in Kentucky. This guide will provide you with clear and supportive instructions to help you complete the form accurately online.

Follow the steps to successfully complete your reinstatement application.

1. Press the ‘Get Form’ button to obtain the Lpca Reinstatement Form Ky and open it for editing.
2. Begin by entering your full name in the designated field. Ensure that the name matches your official identification.
3. Provide your present place of employment by filling out the related section with the name of your employer.
4. Fill out your current address details, including street address, city, state, and zip code accuracy.
5. Enter your home telephone number in the provided field, followed by your business telephone number.
6. Input your home and business email addresses in the respective sections. Ensure both email addresses are active and accessible.
7. Provide your social security number and your license number as required in the form.
8. Answer the questions regarding felony convictions and disciplinary actions. If applicable, provide details on a separate sheet of paper.
9. List any state in which you have obtained licensing or certification since your last renewal, including type and number.
10. Complete the affidavit section by certifying that all information provided is true and correct. Sign in the designated area.
11. Finally, indicate the number of continuing education hours completed in the past year and attach supporting documentation.
12. Once all fields are completed, save your changes, download a copy, print the form, or share it as required.

Get started now by completing your Lpca Reinstatement Form Ky online!