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APPLICATION FOR CERTIFICATION - CASOMB

APPLICATION FOR CERTIFICATION SEX offender TREATMENT PROVIDER INDEPENDENT PROVIDER LEVEL California Sex offender Management Board 1515 S Street, 212 - North, Sacramento, CA 95811 Website: Contact Information for Inquiries Regarding the CERTIFICATION Process is Available at: 2 Sex offender Management Board Independent Provider APPLICATION 8/12/2016 Who should complete this APPLICATION : Every individual who wishes to provide services as a Certified Independent Provider to convicted sex offenders pursuant to Penal Code Section and Sections and 3008 must complete this APPLICATION . Providers must demonstrate that they meet the qualifications and comply with standards of practice contained in Sex offender Treatment Provider CERTIFICATION Requirements, published in June, 2011, by the California Sex offender Management Board ( CASOMB ). This APPLICATION should only be completed by individuals, not partnerships, groups or programs.

APPLICATION FOR CERTIFICATION SEX OFFENDER TREATMENT PROVIDER INDEPENDENT PROVIDER LEVEL California Sex Offender Management Board 1515 S Street, 212 - North, Sacramento, CA 95811 Website: www.casomb.org Contact Information for …

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