Ala. Admin. Code r. 750-X-2A-.03 - Application Form

Applications will be reviewed under the laws and rules and regulations in effect the date the application is received. All licensure applications shall be submitted on a form prescribed and provided by the Board of Examiners in Psychology and accompanied by such evidence, statements, and documents as are therein required. The licensure application form must be filled out legibly and in detail, giving requested information and dates. It shall include a complete list of job positions in chronological sequence. A certified copy of each transcript shall be sent by the registrars of each institution directly to the Board. The applicant shall have the registrar, the graduate school dean, or other approved official of the degree granting institution to certify (1) the degree granting school or college, (2) the exact name of the department which granted the degree, and (3) the exact title of the degree. The entire licensure application form shall be notarized. The Board must be informed if a previous application for licensure has been submitted in this state. Four references are required (see Rule 750-X-2A-.05 below). The licensure application fee or any application for a fee waiver as allowed by these rules must accompany the application form.

All applicants for licensure shall submit to a criminal history background check by providing fingerprints and executing a criminal history information release using forms provided to the applicant by the Board. The applicant is responsible for having his or her fingerprints made. The applicant shall provide his or her completed fingerprint cards, along with a Cashier's Check or Money Order made payable to the Alabama State Law Enforcement Agency (ALEA) in the amount sufficient to cover the actual cost of the background check, to the Board office to be submitted to ALEA. ALEA is responsible for forwarding the fingerprints to the Federal Bureau of Investigation for a national criminal history record check. Information received by the Board pursuant to a criminal history background check shall be confidential and shall not be a public record, except that such information received by and relied upon by the Board in denying the issuance of a certificate of qualification may be disclosed as may be necessary to support the denial.


Ala. Admin. Code r. 750-X-2A-.03
New Rule: Filed November 25, 1997; effective December 30, 1997. Amended: Filed November 15, 2000; effective December 20, 2000. Amended: Filed November 27, 2013; effective February 1, 2014 pursuant to Act No. 2013-386. Amended: Filed March 21, 2014, effective April 25, 2014. Amended by Alabama Administrative Monthly Volume XXXIV, Issue No. 10, July 29, 2016, eff. 8/25/2016. Amended by Alabama Administrative Monthly Volume XLI, Issue No. 02, November 30, 2022, eff. 1/14/2023.

Author: Alabama Board of Examiners in Psychology

Statutory Authority: Code of Ala. 1975, ยงยง 34-26-1, et seq., 34-26-43.

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