Get Illinois Certified Domestic Violence Professional Certification Examination Application Form

This guide provides a clear and supportive approach to filling out the Illinois Certified Domestic Violence Professional Certification Examination Application Form online. By following these steps, users will gain the confidence to complete their application accurately and efficiently.

Follow the steps to successfully complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select the exam date you are applying for by placing an X next to the appropriate date on the form. Ensure you choose a date that fits your schedule.
3. Indicate your preferred exam location by marking the appropriate box for either the Chicago area or Springfield area.
4. Enter the examination fee of $150.00. Prepare a certified check or money order made payable to Continental Testing Services, Inc.
5. Provide your social security number in the designated area.
6. Fill in your full name, ensuring to list your last name, first name, and middle initial clearly.
7. Complete your home address, including the street number and name, city, state, and zip code. Be sure to include any apartment or suite number if applicable.
8. Provide your contact information including your home phone number, cell phone number, and email address.
9. Include your business information, noting the name of your employer and the work address, including any necessary room number.
10. Specify your preferred mailing address by marking whether you want correspondence to go to your home or work address.
11. List any maiden or former surnames if applicable.
12. Enter your daytime telephone number where you can be reached.
13. Provide your date of birth by filling in the month, day, and year.
14. If applicable, check the box for requesting special accommodations such as ADA considerations or language assistance.
15. Certify that you have completed 40 hours of domestic violence training at an ICDVP approved site and attach proof of training.
16. Confirm that you have completed 150 hours of supervised domestic violence work. Attach the supervisor assessment form and include relevant details.
17. Review the ICDVP, Inc. Code of Ethics, and acknowledge your understanding by signing the application.
18. Answer the statement of arrest or conviction questions honestly. Attach additional documentation if any questions are answered yes.
19. Complete the candidate certification and waiver section by reading it thoroughly, then signing and dating the application.
20. Once all sections are filled out, save your changes, download or print the completed form, and prepare to mail it along with your fee to the address provided.

Take the first step towards certification by completing your application online today.