Forms for Certification as an Autism Behavior Interventionist

It is the policy of the Board to not accept character references from family members, supervisors, employees, clients or family of clientele of the applicant. Please be conscious of this when sending out references for application. They will not be accepted.

APPLICATIONS SHOULD NOT BE SUBMITTED TOGETHER. CHARACTER REFERENCES MUST COME UNDER SEPARATE COVER!!!

If you've got questions about the application process? You should check the FAQ section!!

Requirements for Certification

This is a copy of the regulation explaining the requirements for Certification as an Autism Behavior Interventionist

Instructions for Application for Certification

This document describes the instructions for Certificaiton.
pdf document

Application for Certification

This document must be completed and submitted with $100.00 application fee to be considered for Certification
pdf document

Character Reference Form

Three References must be submitted to the Board in support of Application for Certification
pdf document

Supervisor Qualification Form

This form must be completed by a LBA, LaBA or Psychologist in support of Appliction for Certificaiton.
pdf document

Blank forty hour log

Proof of 40 hours of training in ABA techniques is required in support of Application for Certification.
pdf document

Release to Discuss Application-Outside Party

Below release should be signed by applicant if person other than applicant must discuss status, changes and other application information
pdf document