Home Care Aide Certification Application Packet

home care Aide Certification Application Packet Contents: 1. Contents List/SSN Information/Mailing 1 page 2. Certification Requirements and Application Instructions 4 pages 3. home care Aide Certification 7 pages 4. Employment Verification .. 1 page 5. Out-of-State Credential Verification 2 pages 6. RCW/WAC and Online Website 1 page Important Social Security Number Information: You are required by state and federal law to provide a social security number with your Application . If you do not have a social security number at the time you send in this Application , please read, complete, and return this form with your Application . A Individual Taxpayer Identification Number (ITIN) or a Canadian Social Insurance Number (SIN) cannot be substituted.

F 3: Type of Services Provided: Check all that apply: • Long-term care workers who must become certified home care aides. • Individuals who are not required to be a home care aide, but choose to apply.

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