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DVS Initial Application Review
Certification Type
Has the Consent for Release of Information been signed?
Has the application been signed?
Has the applicant submitted verification of a Criminal Background Check?
Has the applicant signed the Professional Code of Ethics?
Have the following evaluations been received? Please check all that apply.
Do any of the evaluations require follow up?
Has the applicant satisfactorily completed all questions in the Self-Evaluation?
Training and Education
Has the applicant completed at least 30 hours of training and education in Core Training categories (I through IV)?
Has the applicant completed 40 hours of training in Direct Service/Systems Advocacy Categories (V through IX)?
Has the applicant completed 40 hours of training in Prevention categories (X through XIII)?
Has the applicant completed 12 mentoring sessions with a certified DVS?
Has the applicant provided sufficient justification for elective topics?
Additional Comments
The Certification Review Pane may, at its discretion, require an interview and/or additional references. I recommend the following for the above named applicant: