GENERAL APPLICATION INSTRUCTIONS These instructions are intended to guide you in completing your Application to become a CASAC or CASAC Trainee. If you do not complete the CASAC process by the expiration date of your CASAC Trainee Extension you will need to submit a new application and a 100 Application It is suggested that you contact the there may be paperwork that you do not have to re-submit. You must select and apply for one of the following options Option 1 - CASAC Trainee EXAM ELIGIBLE Expires in 5 years with an option of a 3-year extension. option for a 3-year extension. Complete application upon initial submission. A copy of your highest level of education completed diploma or transcript. If you are unable to address the identified deficiencies by the end of the five-year period your Application will not be approved and you will not be issued a CASAC Credential. In order be considered for a CASAC in the future you will be required to submit a new Application associated documen....
Open form follow the instructions
Easily sign the form with your finger
Send filled & signed form or save
How to fill out the NY PDS-11 online
The NY PDS-11 is an essential form for individuals seeking the Credentialed Alcoholism and Substance Abuse Counselor (CASAC) certification in New York State. This guide provides clear, step-by-step instructions on how to effectively complete the form online.
Follow the steps to successfully complete the NY PDS-11 form.
- Press the ‘Get Form’ button to access the NY PDS-11, enabling you to open the form in your preferred editor.
- Begin by entering your personal information in Part A of the application summary. Ensure that your name, social security number, and contact details are accurately filled out.
- Complete the Canon of Ethical Principles section by initialing each statement, confirming your understanding and agreement.
- Fill out the education and training requirements within Part D, ensuring to attach all necessary certificates and transcripts to validate your qualifications.
- In Part C, document your work experience by detailing the hours worked and the nature of the services provided. Ensure to have the required supervisor's verification.
- Review all sections of the form for completeness and accuracy, ensuring that all signatures are in place within the designated fields.
- Once the form is complete, save your changes and choose the option to download the form. Print a copy for your records and/or share it as required.
Submit your application online to initiate the credentialing process today.
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Related content
Nov 11, 2019 - PDS-11 November 2019. NYS OASAS-Credentialing Unit. Page 7 of 27. SCOPE OF...
Please do not send cash. Send to: NYS OASAS. Attn: Credentialing Unit. 1450 Western...
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down process here.
This form is available in several versions. Select the version you need from the drop-down list below.