A. Application Packet Upon reading the requirements for professional credentialing in Chapter 3, Section 2, pp. 8-10, and making a decision to apply for Provisionally Certified Mental Retardation Therapist (PCMRT), an individual shall submit to the Division an application packet containing the forms/ materials listed below. These forms verify the provisional certification requirements listed in Chapter 3, Section 2, pp. 8-10.
(1) Application: A completed, notarized Application Form;(2) Employment: A completed Verification of Employment Form from the applicant's current place of employment meeting the employment requirement listed in Chapter 3, Section 2, C., (1), p. 9;(3) Education: An Official Transcript(s) meeting the educational requirements listed in Chapter 3, Section 2, C., (2), p. 9;(4) Experience: A completed Verification of Experience Form(s) meeting the experience requirements listed in Chapter 3, Section 2, C., (3), p. 9; and,(5) Application Fee: A nonrefundable $75.00 check or money order made payable to the Mississippi Department of Mental Health. See Chapter 6, Section 1, A., p. 36 for more information on the Application Fee.