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Page 1Certification Application (CA19) 0815 Commonwealth of Kentucky EDUCATION PROFESSIONAL STANDARDS BOARD rd Division of Certification, 100 Airport Road, 3 Floor, Frankfort, Kentucky 40601 Telephone.

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How to fill out the Certification Application (CA-19) online

Filling out the Certification Application (CA-19) online can be a straightforward process when you understand each component of the form. This guide provides clear, step-by-step instructions to help you successfully complete the application, ensuring that you provide all necessary information.

Follow the steps to complete your Certification Application online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your personal information in Section I. Fill in your social security number, date of birth, last name, first name, middle name, and maiden name. Indicate your gender and select whether you are applying for an initial issuance or renewal of your certification.
  3. Provide your mailing address, including city, state, and zip code, along with your telephone numbers and email addresses. Ensure that your contact information is accurate for any correspondence related to your application.
  4. In Section II, specify your district and position information. Write the district name, district code number, and certification requested. Additionally, include any relevant telephone and fax numbers for further verification.
  5. Complete Section III by ensuring your superintendent verifies your application for initial issuance. Obtain their signature and date on the relevant line. The superintendent should affirm that no qualified teachers are available for the position.
  6. As the teacher, provide your verification by signing and dating in the designated area in Section III. Acknowledge the need for ongoing training and coursework as indicated in the guidelines.
  7. If applicable, fill out Section IV for renewal verification. Ensure the superintendent signs and dates this section as well.
  8. Turn to Section V, where you will disclose any necessary background information. Answer all questions truthfully and attach any required documentation if necessary.
  9. Complete Section VI with your affirmation statement. Sign and date this area, certifying that all information provided is true and complete.
  10. Finally, ensure you have all required attachments, including official transcripts and curriculum guidesheets. After reviewing your application for accuracy, you can save your changes, download the completed form, print it, or share it as needed.

Start filling out your Certification Application online today!

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The program can be completed in 6-15 weeks and requires 50 hours of classroom training and 100 hours of clinical training, that will be under the direct supervision of a Licensed Practical Nurse (LPN) or a Registered Nurse (RN). Some accelerated programs offer 4-week CNA classes as well.

Prospective Administrators must complete an Initial Certification Training Program (ICTP) via Department-approved live training. Administrators seeking recertification, must meet the 40-hour continuing education requirement by completing at least 20 hours of in-person courses.

The examination will consist solely of a Training and Experience Evaluation. To obtain a position on the eligible list, a minimum score of 70% must be received.

Candidates must be at least 16 years old. Pass a physical (health) screening and criminal background check. Complete a California Department of Public Health (CDPH) training program consisting of at least 60 hours of classroom/online theory hours and 100 hours of clinical hands-on supervised training.

CNA stands for “certified nursing assistant,” an entry-level role that provides vital support to both patients and nurses. From transporting, bathing, and feeding hospital patients, to stocking medical supplies and logging patient information, CNAs are on the ground working to enhance patient outcomes.

It must be filled out and signed by the RN in charge of your CNA program. Q: What is a CDPH 932 form? A: CDPH 932 is the form number that you will find in the bottom left hand corner of the Certified Nurse Assistant Competency Evaluation Approval letter that you receive from the state.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232