Get New Applicant Data Sheet - Wvpsychbdorg

Filling out the NEW APPLICANT DATA SHEET is a crucial step in your application process for licensure in psychology in West Virginia. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to fill out the form online.

1. Click the ‘Get Form’ button to access the necessary document and launch it in your preferred editing tool.
2. Begin by entering your name in the designated field labeled 'Name.' Make sure to provide your full legal name.
3. In the 'Degree Earned' section, specify the highest degree you have completed relevant to your application.
4. Fill in your home address, including street address, city, state, and zip code. Ensure all fields are completed for accurate communication.
5. Provide your home telephone number, date of birth, and email address in the respective fields.
6. Next, indicate your current employer by filling out the 'Employer' section, along with the employer’s address.
7. Give the city, county, state, and zip code related to your employer's location.
8. Enter your work telephone number and work fax number as applicable.
9. If you are an unlicensed candidate, list the names of your supervisors in the 'Name(s) of supervisor(s)' section. Include both primary and secondary supervisors.
10. Select the type of license you are applying for by checking the appropriate box (Standard, School Psychology, or Dual).
11. Fill out the college name, degree obtaining, major course of study, minor, and graduation date in their respective fields.
12. Provide your EPPP score in the designated section and ensure the score is correctly scaled.
13. Once all fields are completed, review your information for accuracy. You can then save your changes, download, print, or share the form as needed.

Complete your NEW APPLICANT DATA SHEET online to ensure a smooth application process.