Get Ca Lic 9141 2016-2026
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the CA LIC 9141 online
This guide provides a step-by-step process for completing the CA LIC 9141 form online. Whether you are applying to become a course vendor or renewing your existing certification, this resource will assist you in successfully navigating the form's components.
Follow the steps to complete the CA LIC 9141 form online.
- Click the ‘Get Form’ button to obtain the CA LIC 9141 document and open it in your preferred editing tool.
- Select the type of application by checking the corresponding box for either 'New' or 'Renewal'. If renewing, ensure to provide your vendor number and the expiration date.
- Indicate the type of program by checking one box for ARF, GH, or RCFE. Remember to submit separate applications if applying for more than one.
- Choose the type of vendor by checking one box for either ICTP or CEU. Note the associated fees: $150 for ICTP and $100 for CEU.
- Fill in the applicant information by providing your organization or vendor business name, address, contact person’s name, phone number, fax number, email, and company website.
- Select the appropriate company type by checking one box. Be prepared to provide documentation of your authority to conduct business in California.
- List each individual authorized representative or contact person, including their titles. Ensure that each person completes and signs sections 6-10 of the form.
- Complete sections 6-10 in detail, addressing questions about existing licenses, previous employment in state-licensed facilities, and any legal actions. Ensure the information is current and accurate.
- Provide your printed name and signature as the vendor/authorized representative and fill in the date.
- Finally, save your changes, and once you are finished, you have the option to download, print, or share the form as needed.
Complete your CA LIC 9141 application online today to ensure a seamless process.
Becoming a healthcare administrator in California involves earning a relevant degree, typically in healthcare administration, followed by obtaining the necessary licensure. You should complete a training program that aligns with the state's requirements and prepares you for administrative responsibilities. Successfully completing these steps will lead you to achieve your CA LIC 9141, positioning you for success in the healthcare administration field.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.