INITIAL LICENSE APPLICATION FOR PRIVATE TRADE, VOCATIONAL OR TECHNICAL SCHOOLS

Size: px
Start display at page:

Download "INITIAL LICENSE APPLICATION FOR PRIVATE TRADE, VOCATIONAL OR TECHNICAL SCHOOLS"

Transcription

1 DAVID Y. IGE GOVERNOR KATHRYN S. MATAYOSHI SUPERINTENDENT STATE OF HAWAI`I DEPARTMENT OF EDUCATION nd Avenue, Room 209 Honolulu, Hawaii Phone: (808) Fax: (808) INITIAL LICENSE APPLICATION FOR PRIVATE TRADE, VOCATIONAL OR TECHNICAL SCHOOLS Private Trade, Vocational or Technical (PTVT) School License renewal applications are processed every two years during odd-numbered years (i.e. 2015, 2017, etc.) and are due by July 1 st of the expiring year. Licenses are granted from September 1 to August 31 for two years. The initial licensing fee is $ and must be submitted with the initial application. Until licensed by the Hawaii State Department of Education, no school shall advertise, accept tuition from prospective students, or schedule classes. Instructions and Checklist: Review Hawaii Administrative Rules, Title 8, Chapter 101, Licensing of Private, Trade, Vocational or Technical Schools. All schools and staff must comply with the Hawaii Administrative Rules, Title 8, Chapter 101. A licensed school shall make available a copy of this chapter to members of the staff and students upon request. REQUIRED DOCUMENTS o School Information (PTVT Form 1i) o Request for Initial License (PTVT Form 2i) o Personnel (PTVT Forms 3, 5, 6) Note: Form 4 is not required for the Initial License o Curriculum (PTVT Forms 7-9) Note: Forms 10 and 11 are not required for the Initial License o Projected Summary of Fiscal Operations (PTVT Form 12) o Articles of Incorporation and By Laws o State General Excise Tax License o Brochure/Catalog and Sample of School Certificate o Surety Bond (Affidavit) o License Fee o Facilities o Department of Health o City and County Building Division o City and County Fire Department o Floor Plan o Certification of Applicant AN AFFIRMATIVE ACTION AND EQUAL OPPORTUNITY EMPLOYER

2 INITIAL LICENSE APPLICATION For Private Trade, Vocational, or Technical Schools Instructions and Checklist (continued): SCHOOL INFORMATION o Complete School Information (PTVT Form 1i) REQUEST FOR INITIAL LICENSE o Complete Request for Initial License (PTVT Form 2i) PERSONNEL Instructors Application for Professional Staff Certificate (PTVT Form 3) Evidence that a standard learning period has been completed and passed for the trade or vocation noted (i.e. resume, transcripts, diploma/certificate) Employment verification of a minimum of 5,400 hours (approximately three (3) years) of work experience for the trade or vocation noted Current Hawaii licenses for the trade or vocation noted (i.e. massage, acupuncture, crane operations, etc.) Current and valid tuberculosis clearance certificate Summary of Instructors Form (PTVT Form 5) List all instructors in alphabetical order Submit a revised list if there are changes during the school year Non-Instructional staff members must submit a current and valid tuberculosis (TB) clearance certificate Principal Principal Certification Form (PTVT Form 6) Documentation of Training and Experience Three (3) Letters of Verification Note: After a school has been licensed, any changes shall be reported to the Hawaii State Department of Education within five (5) business days from the date of change. Changes can be sent via to Hawaii State Department of Education 2

3 INITIAL LICENSE APPLICATION For Private Trade, Vocational, or Technical Schools Instructions and Checklist (continued): CURRICULUM Complete Course Log and Information Form (PTVT Form 7) Complete Course Description Form (PTVT Form 8) Complete Course of Study (PTVT Form 9) FISCAL OPERATIONS Complete Projected Summary of Fiscal Operations (PTVT Form 12) BROCHURE/CATALOG Current curriculum (course of study, course descriptions, etc.) Course Fees (Tuition, books, supplies, and other fees) Student Rights Refund Policy Grading Policy Sample Certificate SURETY BOND (AFFIDAVIT) Submit a current affidavit demonstrating Surety Bond is and will be current for the program years of licensure. INITIAL LICENSE FEE Submit Initial License Fee of $ payable to the Hawaii Department of Education. Hawaii Revised Statutes, Section , Assessment and collection of service charges for dishonored payments, requires all DOE schools and offices receiving revenues or other monies on behalf of the State to assess and collect a service charge in the amount of $25.00 for any remittance for payment that is dishonored for any reason. Hawaii State Department of Education 3

4 INITIAL LICENSE APPLICATION For Private Trade, Vocational, or Technical Schools Instructions and Checklist (continued): FACILITIES/CERTIFICATES OF INSPECTION If a school relocates to a new address, it must submit updated health, building, fire, and floor plans. Evidence provided must indicate all requirements have been met. Hawaii State Department of Health County Building Department (which includes the maximum occupant load) Fire Inspection Floor Plan Contact Information Sanitation Compliance Hawaii State Department of Health-Sanitation Branch 591 Ala Moana Blvd., 1st Floor Honolulu, Hawaii Phone: Fire Safety Requirements Fire Prevention Bureau 636 South Street Honolulu, Hawaii Phone: Safety and Building Code Compliance City and County of Honolulu Building Division Department of Planning and Permitting Building Division 650 South King Street #7 Honolulu Hawaii Phone: (leave a voice message to return your call) The Hawaii State Department of Education does not require submission of certificates of clearance showing compliance with the Hawaii Occupation and Safety Health (HIOSH) and the Americans with Disabilities Act (ADA). However, all licensed schools are responsible for the compliance with applicable codes and regulations. For more information and assistance, contact the following offices: Hawaii State Department of Labor and Industrial Relations Hawaii Occupational Safety and Health Division Consultation and Training Branch 830 Punchbowl Street, Room 423 Honolulu, Hawaii Phone: or Note: Go to website and read regulations (http://labor.hawaii.gov/hiosh/about-us/) Disability and Communication Access Board 919 Ala Moana Blvd., Room 101 Honolulu, Hawaii Phone: Hawaii State Department of Education 4

5 CERTIFICATION OF APPLICANT This affidavit must be signed and notarized. INITIAL LICENSE APPLICATION For Private Trade, Vocational, or Technical Schools By submitting this licensing application, I hereby attest that I have reviewed the contents for accuracy. All forms submitted are in compliance with Hawaii Administrative Rules, Title 8, Chapter 101. In addition, I certify the adherence to provisions of the Hawaii Revised Statutes Sections 302A-424 to 302A-428. Signature of Authorized Officer To be signed in the presence of a Notary Public Print Name Title This section to be completed by a Notary Public State of Hawaii, City and County of The officer whose true signature appears above, being duly sworn and deposed, certifies that the facts set forth in the above statements are true. Subscribed and sworn to before me this day of 20 Notary Public Judicial Circuit State of Hawaii My commission expires Hawaii State Department of Education 5

6 SCHOOL INFORMATION (PTVT Form 1i) This information will be used by the Hawaii State Department of Education if a license is approved for this school. Name of School Provider/Owner (Registered Trade Name) School Address (Classroom Location) Business/Mailing Address Business Telephone Fax Number E mail Address Web Page URL School Administrator (Principal) School Administrator s Residence Address Phone Number E mail Address Vocation(s) List State General Excise Tax Number Hawaii State Department of Education Page 1 of 1

7 REQUEST FOR INITIAL LICENSE (PTVT Form 2i) The school license is limited to the specific Name, Location, and Vocation as stated on the license. School Name Location Vocation(s) List Form of Ownership Corporation Partnership Sole Proprietorship Limited Liability Company (LLC) Limited Liability Partnership (LLP) List all individuals who own 5 percent or more of the school: Legal Name Mailing Address E Mail Address Have any of the individuals listed above ever: 1. Been connected in any capacity with a private trade, vocational, or technical school of any type? If yes, explain. 2. Been convicted for violating the penal laws of the United States related to the profession or business for which this license is being sought? If yes, explain. Hawaii State Department of Education Page 1 of 1

8 APPLICATION FOR PROFESSIONAL STAFF CERTIFICATE (PTVT Form 3) Complete this form and attach the following for each instructor: Evidence that a standard learning period has been completed and passed for the trade or vocation noted (i.e. resume, transcripts, diploma/certificate) Employment verification of a minimum of 5,400 hours (approximately three (3) years) of work experience for the trade or vocation noted Current Hawaii licenses for the trade or vocation noted if required of instructors by law or ordinance Current and valid tuberculosis clearance certificate A. PERSONAL INFORMATION Legal Name (Last, First, Middle) Social Security Number xxx xx Mailing Address Phone Number E mail Address Trade/Vocation Certification Areas B. EDUCATIONAL AND PROFESSIONAL TRAINING Name and Location of Schools Attended (High, Technical, Vocational Schools and Colleges) Area of Study or Major From (mm/yy) To (mm/yy) Certificates Diplomas Degrees Award (mm/yy) C. TEACHING EXPERIENCE (if none leave blank) Name and Location of Schools Attended (High, Technical, Vocational Schools and Colleges) Discipline or Area Taught From (mm/yy) To (mm/yy) Years Months D. WORK EXPERIENCE OTHER THAN TEACHING Name and Location of Firm Nature of Work From (mm/yy) To (mm/yy) Years Months Hawaii State Department of Education Page 1 of 2

9 APPLICATION FOR PROFESSIONAL STAFF CERTIFICATE (PTVT Form 3) E. APPLICANT CERTIFICATION STATEMENT I certify that the foregoing information in Sections A, B, C, and D are correct to the best of my knowledge. I have also attached the required documents. Signature of Applicant F. ASSURANCES BY THE PRINCIPAL All documents necessary to apply for the Professional Staff Certificate (PSC) are attached. I have reviewed and verified the applicant s training, background, and experience. The applicant is qualified to serve as an instructor and a member of my teaching faculty. Name of School Signature of Principal Hawaii State Department of Education Page 2 of 2

10 SUMMARY OF INSTRUCTORS FORM (PTVT Form 5) Instructions List all instructors in alphabetical order Submit a revised list if there are changes since the last application Non Instructional staff members must submit a current and valid tuberculosis (TB) clearance certificate A. NEW INSTRUCTIONAL STAFF Legal Name (Last, First, Middle) Individual Licensure Social Security Number xxx xx Course(s) Taught Commission on Board License Number Expiration Teacher Certificate No. Legal Name (Last, First, Middle) Individual Licensure Social Security Number xxx xx Course(s) Taught Commission on Board License Number Expiration Teacher Certificate No. Legal Name (Last, First, Middle) Individual Licensure Social Security Number xxx xx Course(s) Taught Commission on Board License Number Expiration Teacher Certificate No. Legal Name (Last, First, Middle) Individual Licensure Social Security Number xxx xx Course(s) Taught Commission on Board License Number Expiration Teacher Certificate No. B. NON INSTRUCTIONAL STAFF (Attach TB clearance certificate) Legal Name (Last, First, Middle) Position Hawaii State Department of Education Page 1 of 2

11 SUMMARY OF INSTRUCTORS FORM (PTVT Form 5) C. RETURNING STAFF (Must have Application for Professional Staff Certificate on file) Legal Name (Last, First, Middle) Teacher Certificate No. D. PRINCIPAL S SIGNATURE Name of School Total Number of Staff Signature of Principal Hawaii State Department of Education Page 2 of 2

12 PRINCIPAL CERTIFICATION FORM (PTVT Form 6) Complete this form and attach the following: Documentation of Training and Experience Three (3) Letters of Verification testifying to the character, ability, and competency to operate the school as proposed A. PERSONAL INFORMATION Legal Name (Last, First, Middle) Social Security Number xxx xx Mailing Address Phone Number E mail Address Name of School B. CERTIFICATION I certify that I have adequate training and experience to be principal of the school. As principal of the school, I shall be responsible for: Complying with all applicable State, County, and Department of Education policies. Providing reports and information as required by the Department of Education. Informing the Department of Education of changes in school policies, programs, facilities, tuition, calendar, and all other matters affecting the status of the school as originally licensed. Providing all advertisements, recruitment procedures employed by representatives of the school, published materials, and public relations activities. Directing and supervising the school s staff and program. Assuring that all facilities comply with State and City and County requirements. Signature of Principal C. OWNER VERIFICATION AND ASSURANCE The above individual will serve as principal of the school. Evidence of the following is attached: Documentation of Training and Experience Three (3) Letters of Verification testifying to the character, ability, and competency to operate the school as proposed I shall comply with all applicable State, County, and Department of Education policies. Signature of Owner Hawaii State Department of Education Page 1 of 1

13 COURSE LOG AND INFORMATION FORM (PTVT Form 7) Instructions Submit one sheet for each vocation/trade Evening classes must be approved by the Hawaii State Department of Education A. SCHOOL INFORMATION School Vocation/Trade Unit measurement utilized by school: Trimester Quarter Credit Clock Hours Signature of Principal B. COURSE LOG AND INFORMATION Course Title Instructor Time of Class Start Finish Class s Start Finish Length of Class Credits or Clock Hours Projected Enrollment Night Course? Yes or No Hawaii State Department of Education Page 1 of 1

14 COURSE DESCRIPTION FORM (PTVT Form 8) Submit one form for each course/class. A. SCHOOL INFORMATION School Vocation/Trade B. COURSE DESCRIPTION Course Title Instructor(s) Projected Enrollment Curriculum Description (What will be covered in the course/class and what equipment will be needed?) Objectives or Standards: (What is the expectation of the student at the end of the course/class?) Evaluation: (How will the instructor evaluate the successful completion of the course/class?) C. LENGTH OF COURSE/CLASS Total Weeks Total Days Number of Sessions Number of Credits/Clock Hours First Class Last Class D. EXPENSES FOR THE COURSE/CLASS Tuition Books Registration Fees Other Fees E. PRINCIPAL SIGNATURE Signature of Principal Hawaii State Department of Education Page 1 of 1

15 COURSE OF STUDY (PTVT Form 9) Instructions Submit one sheet for each Vocation/Trade A. SCHOOL INFORMATION Name of School Vocation/Trade Signature of Principal B. COURSE OF STUDY C. DOCUMENTATION UPON COMPLETION Upon completion of the above, the student will receive the following: Certificate Transcript Other: Hawaii State Department of Education Page 1 of 1

16 PROJECTED SUMMARY OF FISCAL OPERATIONS (PTVT Form 12) A. SCHOOL INFORMATION Name of School Signature of Principal B. PROJECTED INCOME AND EXPENDITURES INCOME EXPENDITURES Registration $ Salaries $ Student Tuition $ Rent $ Federal Reimbursement $ Instructional Materials $ State Reimbursement $ Furniture $ Private Reimbursement $ Utilities $ Books/Supplies $ Office Supplies $ Other Fees (List) Other Expenses (List) TOTAL $ TOTAL $ C. PROJECTED NET PROFIT/LOSS Subtract income total from expenditure total $ D. ASSETS AND DEBTS Name of Lender Address Amount Capital Assets (Cash) $ $ Other Assets $ $ Debts $ $ Hawaii State Department of Education Page 1 of 1

LICENSE RENEWAL APPLICATION FOR PRIVATE TRADE, VOCATIONAL OR TECHNICAL SCHOOLS

LICENSE RENEWAL APPLICATION FOR PRIVATE TRADE, VOCATIONAL OR TECHNICAL SCHOOLS DAVID Y. IGE GOVERNOR KATHRYN S. MATAYOSHI SUPERINTENDENT STATE OF HAWAI`I DEPARTMENT OF EDUCATION 475 22 nd Avenue, Room 209 Honolulu, Hawaii 96816 Phone: (808) 305-9755 Fax: (808) 733-9154 E-mail: ptvt@hawaiidoe.k12.hi.us

More information

School ID/ Certificate Number SED CODE

School ID/ Certificate Number SED CODE New York State Education Department Bureau of Proprietary School Supervision Applicant Instructions Application for Transfer of a Certification to Operate an ESL School in New York State BPSS-4 For Office

More information

SALE OF CHECKS,TRANSMISSION OF MONEY LICENSE APPLICATION (Chapter 23, Title 5, Del.C.)

SALE OF CHECKS,TRANSMISSION OF MONEY LICENSE APPLICATION (Chapter 23, Title 5, Del.C.) FOR OFFICE USE ONLY: Inv. Fee: Check No: Receipt No: STATE OF DELAWARE OFFICE OF THE STATE BANK COMMISSIONER 555 EAST LOOCKERMAN STREET SUITE 210 DOVER, DELAWARE 19901 SALE OF CHECKS,TRANSMISSION OF MONEY

More information

Massage Therapy Educational Program Application for Basic 500-Hour Program

Massage Therapy Educational Program Application for Basic 500-Hour Program Professional Licensing & Certification Unit Massage Therapy Licensing Program P.O. Box 149347, Mail Code 1982 Austin, Texas 78714-9347 (512) 834-6616 www.dshs.state.tx.us/massage Massage Therapy Educational

More information

PRIVATE PROVIDER REQUIREMENTS General Information and Checklist Rev. 10-01-2014

PRIVATE PROVIDER REQUIREMENTS General Information and Checklist Rev. 10-01-2014 PRIVATE PROVIDER REQUIREMENTS General Information and Checklist Rev. 10-01-2014 The use of Private Providers is authorized by Florida Statute 553.791 (Alternative Plans Review and Inspection). The City

More information

2. List of ALL business names under which the corporation, LLC, or LLP provides services.

2. List of ALL business names under which the corporation, LLC, or LLP provides services. State of Alaska Department of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing Board of Registration for Architects, Engineers and Land Surveyors

More information

Instructions to Apply for Registration as a Health Care Services Firm (N.J.A.C. 13:45B-13.3)

Instructions to Apply for Registration as a Health Care Services Firm (N.J.A.C. 13:45B-13.3) New Jersey Office of the Attorney General Division of Consumer Affairs Office of Consumer Protection Regulated Business Section 124 Halsey Street, 7th Floor, P.O. Box 45028 Newark, NJ 07101 (973) 504-6370

More information

APPLICATION FOR LICENSE TO OPERATE ALARM BUSINESS AS DEFINED BY CHAPTER 720, ST. LOUIS COUNTY REVISED ORDINANCES

APPLICATION FOR LICENSE TO OPERATE ALARM BUSINESS AS DEFINED BY CHAPTER 720, ST. LOUIS COUNTY REVISED ORDINANCES APPLICATION FOR LICENSE TO OPERATE ALARM BUSINESS AS DEFINED BY CHAPTER 720, ST. LOUIS COUNTY REVISED ORDINANCES 1. of Applicant (Corporation if a Corporation, Parent Corporation if Different from Subsidiary,

More information

ARTICLE 5. INVESTIGATIONS AND HEARING PROCEDURES R4-39-101. Definitions. Section

ARTICLE 5. INVESTIGATIONS AND HEARING PROCEDURES R4-39-101. Definitions. Section Arizona Administrative Code Title 4, Ch. 39 TITLE 4. PROFESSIONS AND OCCUPATIONS CHAPTER 39. BOARD FOR PRIVATE POSTSECONDARY EDUCATION (Authority: A.R.S. 32-3001 et seq.) Former Article 1 consisting of

More information

INSTRUCTIONS FOR APPLICATION FOR LICENSE TO OPERATE ALARM BUSINESS AS DEFINED BY CHAPTER 720, ST. LOUIS COUNTY REVISED ORDINANCES

INSTRUCTIONS FOR APPLICATION FOR LICENSE TO OPERATE ALARM BUSINESS AS DEFINED BY CHAPTER 720, ST. LOUIS COUNTY REVISED ORDINANCES INSTRUCTIONS FOR APPLICATION FOR LICENSE TO OPERATE ALARM BUSINESS AS DEFINED BY CHAPTER 720, ST. LOUIS COUNTY REVISED ORDINANCES 1. Fill out the attached application. Every question must be answered.

More information

Secretary of State Lincoln, NE 68509 DEBT MANAGEMENT LICENSE APPLICATION Initial Fee: $200.00 Investigation Fee: $200.00

Secretary of State Lincoln, NE 68509 DEBT MANAGEMENT LICENSE APPLICATION Initial Fee: $200.00 Investigation Fee: $200.00 JOHN A. GALE 1305 State Capitol Secretary of State Lincoln, NE 68509 DEBT MANAGEMENT LICENSE APPLICATION Initial Fee: $200.00 Investigation Fee: $200.00 Date of Application Applicant is a: Individual Partnership

More information

ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION

ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION MEMORANDUM TO: ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION RE: LICENSING AND REGISTRATION REQUIREMENTS FOR LOAN BROKERS

More information

Department. The Department of Education of the Commonwealth of Massachusetts.

Department. The Department of Education of the Commonwealth of Massachusetts. 603 CMR 3.00: PRIVATE OCCUPATIONAL SCHOOLS Section 3.01: Definitions 3.02: General Provisions 3.03: Application Process 3.04: Registered Schools 3.05: Sales Representatives 3.06: Surety Requirement 3.07:

More information

State of New Jersey Department of Banking & Insurance. Annual Report Worksheet for Foreign Money Transmitters. Year Ending December 31, 2012

State of New Jersey Department of Banking & Insurance. Annual Report Worksheet for Foreign Money Transmitters. Year Ending December 31, 2012 State of New Jersey Department of Banking & Insurance for Foreign Money Transmitters New Jersey Department of Banking & Insurance Division of Banking Attn: Kristen Graham 5 th floor 20 West State Street

More information

ARIZONA STATE BOARD OF EXAMINERS OF NURSING CARE INSTITUTION ADMINISTRATORS AND ASSISTED LIVING MANAGERS

ARIZONA STATE BOARD OF EXAMINERS OF NURSING CARE INSTITUTION ADMINISTRATORS AND ASSISTED LIVING MANAGERS ARIZONA STATE BOARD OF EXAMINERS OF NURSING CARE INSTITUTION ADMINISTRATORS AND ASSISTED LIVING MANAGERS Assisted Living Facility Manager Training Program Application Revised 8/20/15 1 Douglas A. Ducey

More information

ANY INVALID WILL NOT

ANY INVALID WILL NOT NOTICE!! THIS IS AN OFFICIAL DOCUMENT THAT IS USED TO DETERMINE THE QUALIFICATIONS OF CONTRACTORS TO BID WITH THE AGENCY OF TRANSPORTATION FOR THE STATE OF VERMONT. ANY ALTERATIONS OF THIS DOCUMENT WILL

More information

THIS RENEWAL IS DUE ON OR BEFORE DECEMBER 1, 2015 DEBT MANAGEMENT ACT 2016 LICENSE RENEWAL CHECKLIST

THIS RENEWAL IS DUE ON OR BEFORE DECEMBER 1, 2015 DEBT MANAGEMENT ACT 2016 LICENSE RENEWAL CHECKLIST THIS RENEWAL IS DUE ON OR BEFORE DECEMBER 1, 2015 DEBT MANAGEMENT ACT 2016 LICENSE RENEWAL CHECKLIST RENEWAL APPLICATION COMPLETED AND SIGNED CURRENT CLIENT AGREEMENT SURETY BOND IN THE SUM OF $25,000

More information

APPLICATION FOR A TEACHER S LICENSE - DENTISTRY OR DENTAL HYGIENE

APPLICATION FOR A TEACHER S LICENSE - DENTISTRY OR DENTAL HYGIENE Maryland State Board of Dental Examiners Spring Grove Hospital Center Benjamin Rush Building 55 Wade Avenue Catonsville, Maryland 21228 (410) 402-8510 APPLICATION FOR A TEACHER S LICENSE - DENTISTRY OR

More information

APPLICATION FOR ATTORNEY BOND ACCOUNT OF SUBMITTED FOR CONSIDERATION BY THE DALLAS COUNTY SHERIFF S DEPARTMENT

APPLICATION FOR ATTORNEY BOND ACCOUNT OF SUBMITTED FOR CONSIDERATION BY THE DALLAS COUNTY SHERIFF S DEPARTMENT APPLICATION FOR ATTORNEY BOND ACCOUNT OF SUBMITTED FOR CONSIDERATION BY THE DALLAS COUNTY SHERIFF S DEPARTMENT DALLAS COUNTY SHERIFF S DEPARTMENT ATTORNEY BOND ACCOUNT CHECK OFF LIST TO OPEN AN ATTORNEY

More information

DEBT MANAGEMENT COMPANY LICENSE APPLICATION

DEBT MANAGEMENT COMPANY LICENSE APPLICATION State of Indiana DEPARTMENT OF FINANCIAL INSTITUTIONS 30 South Meridian Street, Suite 300 Indianapolis, Indiana 46204 State Form 50291(R8/10) Approved State Board of Accounts 2001 DEBT MANAGEMENT COMPANY

More information

For any questions contact: City Clerk Michelle Tesser Tel: 651-450-2513 Fax: 651-259-8023 mtesser@invergroveheights.org

For any questions contact: City Clerk Michelle Tesser Tel: 651-450-2513 Fax: 651-259-8023 mtesser@invergroveheights.org INSTRUCTIONS FOR THE APPLICATION OF MASSAGE THERAPIST LICENSE THERAPEUTIC MASSAGE BUSINESS LICENSE City of Inver Grove Heights 8150 Barbara Ave, Inver Grove Heights, MN 55077 (651) 450-2500 Fax (651) 450-2502

More information

STATE OF DELAWARE OFFICE OF THE STATE BANK COMMISSIONER 555 EAST LOOCKERMAN STREET SUITE 210 DOVER, DELAWARE 19901

STATE OF DELAWARE OFFICE OF THE STATE BANK COMMISSIONER 555 EAST LOOCKERMAN STREET SUITE 210 DOVER, DELAWARE 19901 FOR OFFICE USE ONLY: Inv. Fee: Check No: Receipt No:_ STATE OF DELAWARE OFFICE OF THE STATE BANK COMMISSIONER 555 EAST LOOCKERMAN STREET SUITE 210 DOVER, DELAWARE 19901 LICENSED LENDER APPLICATION (Chapter

More information

VIDEO GAMING TERMINAL COLLATERAL LENDER REGISTRATION FORM (Pursuant to Video Gaming Adopted Rule 1800.930)

VIDEO GAMING TERMINAL COLLATERAL LENDER REGISTRATION FORM (Pursuant to Video Gaming Adopted Rule 1800.930) ILLINOIS GAMING BOARD 160 North LaSalle Street, 3 rd Floor Chicago, Illinois 60601 312-814-4700 VIDEO GAMING TERMINAL COLLATERAL LENDER REGISTRATION FORM (Pursuant to Video Gaming Adopted Rule 1800.930)

More information

REGISTRATION of A TRADE SCHOOL

REGISTRATION of A TRADE SCHOOL Application for REGISTRATION of A TRADE SCHOOL Under the Trade School Regulation Act Registrar Trades School Regulation Act Government of Yukon Department of Education Advanced Education Branch Fax (867)

More information

Minnesota Appraisal Management Company License Application Required Forms

Minnesota Appraisal Management Company License Application Required Forms MINNESOTA DEPARTMENT OF COMMERCE 85 7th PLACE EAST, SUITE 500 ST. PAUL, MINNESOTA 55101 (651) 539-1599 Appraisal Management Company Application Required Forms Minnesota Statute 82C Minnesota Appraisal

More information

*NOTICE * THIS APPLICATION WAS REVISED IN JUNE 2015 PLEASE READ CAREFULLY

*NOTICE * THIS APPLICATION WAS REVISED IN JUNE 2015 PLEASE READ CAREFULLY *NOTICE * THIS APPLICATION WAS REVISED IN JUNE 2015 PLEASE READ CAREFULLY Change of Ownership License Application To Operate an Abortion or Reproductive Health Center Regulations affecting the application

More information

VERMONT DEPARTMENT OF BANKING, INSURANCE, SECURITIES AND HEALTH CARE ADMINISTRATION INFORMATION FOR COMPLETING BIOGRAPHICAL REPORT

VERMONT DEPARTMENT OF BANKING, INSURANCE, SECURITIES AND HEALTH CARE ADMINISTRATION INFORMATION FOR COMPLETING BIOGRAPHICAL REPORT Attachment B (5/2000) VERMONT DEPARTMENT OF BANKING, INSURANCE, SECURITIES AND HEALTH CARE ADMINISTRATION INFORMATION FOR COMPLETING BIOGRAPHICAL REPORT Biographical Reports must be filed by each director,

More information

Company New Application Checklist Jurisdiction-Specific Requirements

Company New Application Checklist Jurisdiction-Specific Requirements Company New Application Checklist Jurisdiction-Specific Requirements MA MASSACHUSETTS DEBT COLLECTOR LICENSE This document includes instructions for a company (corporation location) new application request.

More information

HOW TO OBTAIN A NEW CONTRACTOR LICENSE

HOW TO OBTAIN A NEW CONTRACTOR LICENSE HOW TO OBTAIN A NEW CONTRACTOR LICENSE These instructions apply to new licenses only. If you wish to add a classification or a qualifying party to an existing license, please see HOW TO ADD A CLASSIFICATION

More information

STATE OF DELAWARE OFFICE OF THE STATE BANK COMMISSIONER 555 E. LOOCKERMAN STREET, SUITE 210 DOVER, DELAWARE 19901

STATE OF DELAWARE OFFICE OF THE STATE BANK COMMISSIONER 555 E. LOOCKERMAN STREET, SUITE 210 DOVER, DELAWARE 19901 STATE OF DELAWARE OFFICE OF THE STATE BANK COMMISSIONER 555 E. LOOCKERMAN STREET, SUITE 210 DOVER, DELAWARE 19901 RENEWAL APPLICATION FOR LICENSE UNDER CHAPTER 22 LICENSED LENDERS Website Address: 1. Name

More information

PROCEDURES FOR THE NONPUBLIC AGING SCHOOLS PROGRAM (FISCAL YEAR 2015)

PROCEDURES FOR THE NONPUBLIC AGING SCHOOLS PROGRAM (FISCAL YEAR 2015) PROCEDURES FOR THE NONPUBLIC AGING SCHOOLS PROGRAM (FISCAL YEAR 2015) August 2014 These procedures are available for download at: http://www.pscp.state.md.us Applications for this program must be submitted

More information

Athletic Trainer License Application Methods

Athletic Trainer License Application Methods Athletic Trainer License Application Methods Please read carefully to determine the application method for which you are qualified Indicate the appropriate method on the application and submit the required

More information

Dear Business Owner: Felicia Holmes Senior Analyst, Procurement Services Osceola County Board of County Commissioners

Dear Business Owner: Felicia Holmes Senior Analyst, Procurement Services Osceola County Board of County Commissioners Dear Business Owner: Welcome to the Local Small Business Enterprise (LSBE) Program! We appreciate your interest in doing business with the Osceola County Board of County Commissioners. In an effort to

More information

STATE OF MAINE. DEPARTMENT OF EDUCATION OFFICE OF HIGHER EDUCATION 23 State House Station Augusta, Maine 04333

STATE OF MAINE. DEPARTMENT OF EDUCATION OFFICE OF HIGHER EDUCATION 23 State House Station Augusta, Maine 04333 STATE OF MAINE DEPARTMENT OF EDUCATION OFFICE OF HIGHER EDUCATION 23 State House Station Augusta, Maine 04333 Application Private Business, Trade and Technical School Certificate of License Under The Statutes

More information

Full Review & New Schools

Full Review & New Schools APPLICATION PACKET Full Review & New Schools MINNESOTA OFFICE OF HIGHER EDUCATION PRIVATE CAREER SCHOOL LICENSE Enclosed are the application forms you must complete to apply for a Minnesota Private Career

More information

APPLICATION INSTRUCTIONS FOR A MASSAGE ESTABLISHMENT LICENSURE APPLICATION CHECK SHEET

APPLICATION INSTRUCTIONS FOR A MASSAGE ESTABLISHMENT LICENSURE APPLICATION CHECK SHEET STATE OF TENNESSEE DEPARTMENT OF HEALTH 665 MAINSTREAM DRIVE NASHVILLE, TN 37243 TENNESSEE MASSAGE LICENSURE BOARD (615) 253-2111 or 1-800-778-4123 ext. 2532111 APPLICATION INSTRUCTIONS FOR A MASSAGE ESTABLISHMENT

More information

FIRM APPROVAL OF BIDDER'S PROOF OF RESPONSIBILITY DATE RECEIVED PRE-QUALIFIED BY DATE CLASS OF WORK DESCRIPTION OF JOB LOCATION OF JOB DEPARTMENT

FIRM APPROVAL OF BIDDER'S PROOF OF RESPONSIBILITY DATE RECEIVED PRE-QUALIFIED BY DATE CLASS OF WORK DESCRIPTION OF JOB LOCATION OF JOB DEPARTMENT To: Shelly Billingsley, P.E. Director of Engineering Division 625 52nd Street Kenosha, Wisconsin 53140 FIRM APPROVAL OF BIDDER'S PROOF OF RESPONSIBILITY DATE RECEIVED PRE-QUALIFIED BY DATE CLASS OF WORK

More information

APPLICATION FOR RENEWAL, CONVERSION, OR AMENDMENT OF LICENSE

APPLICATION FOR RENEWAL, CONVERSION, OR AMENDMENT OF LICENSE GOVERNMENT OF THE DISTRICT OF COLUMBIA Education Licensure Commission APPLICATION FOR RENEWAL, CONVERSION, OR AMENDMENT OF LICENSE 810 First Street, NE 9th Floor Washington, DC 20002 Phone: (202) 727-2824

More information

BUSINESS LOAN APPLICATION

BUSINESS LOAN APPLICATION BUSINESS LOAN APPLICATION One Commerce Park P. O. Box 160 Shallowater,Texas 79363 Phone - 806.832.4525 Fax - 806.832.5849 EMAIL ADDRESS - MARK@FSBSHALLOWATER.COM Page 9 of 23 Commercial Loan Application:

More information

STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT

STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR A LICENSE UNDER THE CALIFORNIA FINANCE LENDERS LAW (CFLL) WHO IS REQUIRED TO OBTAIN A FINANCE LENDERS

More information

CITY OF LITTLE CANADA APPLICATION FOR MASSAGE THERAPY ESTABLISHMENT LICENSE

CITY OF LITTLE CANADA APPLICATION FOR MASSAGE THERAPY ESTABLISHMENT LICENSE CITY OF LITTLE CANADA APPLICATION FOR MASSAGE THERAPY ESTABLISHMENT LICENSE Massage Therapy Principal Use License Fee $300 Massage Therapy Accessory Use License Fee $100 (Accessory or incidental use to

More information

INSTRUCTIONS FOR LEASING/RENTAL MOTOR VEHICLE LICENSE

INSTRUCTIONS FOR LEASING/RENTAL MOTOR VEHICLE LICENSE NEW Application: STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DIVISION OF MOTOR VEHICLES DEALERS' LICENSE AND REGULATION OFFICE 600 New London Avenue Cranston, RI 02920-3024 INSTRUCTIONS FOR LEASING/RENTAL

More information

APPLICATION FOR LICENSURE AS AN INSTALLMENT SELLER

APPLICATION FOR LICENSURE AS AN INSTALLMENT SELLER APPLICATION FOR LICENSURE AS AN INSTALLMENT SELLER PART 1 The Pennsylvania Department of Banking and Securities (the Department) welcomes your request for this Installment Seller application. It is the

More information

2016-2017 Liquor License Application Applicant Name:

2016-2017 Liquor License Application Applicant Name: Cook County Liquor Control Commission 118 N. Clark Street, Room 1160 Chicago, Illinois 60602 (312) 603-3727 (312) 603-5771 (fax) Toni Preckwinkle President Cook County Board of Commissioners Zahra Ali

More information

SOUTH CAROLINA STATE BOARD OF COSMETOLOGY

SOUTH CAROLINA STATE BOARD OF COSMETOLOGY SOUTH CAROLINA STATE BOARD OF COSMETOLOGY INSTRUCTIONS FOR SCHOOL APPLICATION YOUR APPLICATION PACKET SHOULD INCLUDE: 1. FLOOR PLANS. 2. SURETY BOND. 3. STUDENT CONTRACT. 4. CURRICULUM. 5. CHECK OR MONEY

More information

LICENSE FEE: $300 fee must be submitted at the time of application. Make checks payable to: City of Milwaukee.

LICENSE FEE: $300 fee must be submitted at the time of application. Make checks payable to: City of Milwaukee. ccl-160 (12/10) PRIVATE ALARM BUSINESS LICENSE INFORMATION SHEET OFFICE OF THE CITY CLERK LICENSE DIVISION 200 E. WELLS ST. ROOM 105, MILWAUKEE, WI 53202 (414) 286-2238 E-MAIL ADDRESS: LICENSE@MILWAUKEE.GOV

More information

NORTH CAROLINA COMMUNITY COLLEGE SYSTEM Dr. R. Scott Ralls, President. November 16, 2009

NORTH CAROLINA COMMUNITY COLLEGE SYSTEM Dr. R. Scott Ralls, President. November 16, 2009 NORTH CAROLINA COMMUNITY COLLEGE SYSTEM Dr. R. Scott Ralls, President November 16, 2009 IMPORTANT ADMINISTRATIVE CODE INFORMATION MEMORANDUM TO: FROM: SUBJ: Members of the State Board of Community Colleges

More information

Initial Application for Debt Management License Attachments and Instructions

Initial Application for Debt Management License Attachments and Instructions FIS 0506 (05/15) Department of Insurance and Financial Services Page 1 of 3 Initial Application for Debt Management License Initial Application for Debt Management License Attachments and Instructions

More information

NEW/RENEWAL APPLICATION FOR PAIN MANAGEMENT CLINIC REGISTRATION

NEW/RENEWAL APPLICATION FOR PAIN MANAGEMENT CLINIC REGISTRATION Department of Regulatory and Economic Resources Business Affairs Division Office of Consumer Protection 601 NW 1st Court, 18th Floor Miami, Florida 33136 Tel: 786-469-2300 Fax: 786-469-2311 email: license@miamidade.gov

More information

INFORMATION FOR ASBESTOS HANDLING LICENSE APPLICANTS

INFORMATION FOR ASBESTOS HANDLING LICENSE APPLICANTS STATE OF NEW YORK > DEPARTMENT OF LABOR DIVISION OF SAFETY AND HEALTH LICENSE AND CERTIFICATE UNIT BUILDING 12, ROOM 161 STATE CAMPUS ALBANY, NY 12240 (518) 457>2735 GENERAL INFORMATION INFORMATION FOR

More information

APPLICATION FOR ELECTRICIAN'S LICENSE IOWA ELECTRICAL EXAMINING BOARD

APPLICATION FOR ELECTRICIAN'S LICENSE IOWA ELECTRICAL EXAMINING BOARD APPLICATION FOR ELECTRICIAN'S LICENSE IOWA ELECTRICAL EXAMINING BOARD SUBMIT TO: ELECTRICAL EXAMINING BOARD 215 EAST 7 TH STREET DES MOINES, IA 50319 APPLICABLE LICENSE FEE PAYABLE TO IOWA ELECTRICAL EXAMINING

More information

Postsecondary School of Massage Therapy Application

Postsecondary School of Massage Therapy Application Arkansas Department of Health Massage Therapy Section 4815 West Markham, Slot #8 Little Rock, AR 72205 Phone: (501) 683-1448 Fax: (501) 682-5640 Postsecondary School of Massage Therapy Application Regardless

More information

DEBT CONSOLIDATION AGENCY REGISTRATION APPLICATION

DEBT CONSOLIDATION AGENCY REGISTRATION APPLICATION DEBT CONSOLIDATION AGENCY REGISTRATION APPLICATION 1. Company information: Name: Physical address: Mailing address: Phone: For profit: Yes No Not-for-profit: Yes No Manager s name (interested parties list,

More information

APPLICATION FOR DOMESTIC RECIPROCITY LICENSE. The State Board of Cosmetology may grant license by reciprocity, without examination, if:

APPLICATION FOR DOMESTIC RECIPROCITY LICENSE. The State Board of Cosmetology may grant license by reciprocity, without examination, if: 2401 NW 23rd Street, Suite 84 Reciprocity Department 405.522.7620 Fax 405.521.2440 MARY FALLIN GOVERNOR SHERRY G. LEWELLING EXECUTIVE DIRECTOR APPLICATION FOR DOMESTIC RECIPROCITY LICENSE The State Board

More information

January 21, 2015 Memorandum 2015 1C. A. File all documents directly with the Insurance Division, Captive Insurance Branch.

January 21, 2015 Memorandum 2015 1C. A. File all documents directly with the Insurance Division, Captive Insurance Branch. DAVID Y. IGE GOVERNOR SHAN S. TSUTSUI LT. GOVERNOR STATE OF HAW AI`I INSURANCE DIVISION DEPARTMENT OF COMMERCE & CONSUMER AFFAIRS P. O. BOX 3614 HONOLULU, HAWAI`I 968113614 335 MERCHANT STREET, ROOM 13

More information

Arizona Department of Real Estate (ADRE) Education Division www.azre.gov REAL ESTATE SCHOOL CERTIFICATION APPROVAL APPLICATION (ED-100)

Arizona Department of Real Estate (ADRE) Education Division www.azre.gov REAL ESTATE SCHOOL CERTIFICATION APPROVAL APPLICATION (ED-100) Arizona Department of Real Estate (ADRE) Education Division www.azre.gov 2910 N. 44 th Street Phoenix, AZ 85018 DOUGLAS A. DUCEY Governor JUDY LOWE Commissioner REAL ESTATE SCHOOL CERTIFICATION APPROVAL

More information

AUDIOLOGY APPLICATION FOR FULL LICENSURE

AUDIOLOGY APPLICATION FOR FULL LICENSURE DEPARTMENT OF HEALTH AND MENTAL HYGIENE BOARD OF EXAMINERS FOR AUDIOLOGISTS, HEARING AID DISPENSERS AND SPEECH-LANGUAGE PATHOLOGISTS 4201 PATTERSON AVENUE BALTIMORE, MARYLAND 21215-2299 PHONE 410-764-4725

More information

CONTRACTOR QUALIFICATIONS STATEMENT

CONTRACTOR QUALIFICATIONS STATEMENT Page 1 of 6 CONTRACTOR QUALIFICATIONS STATEMENT The undersigned certifies under oath the truth and correctness of all statements and of all answers to questions made hereinafter. SUBMITTED TO: St. Vrain

More information

APPLICATION FOR NATIONAL EXAMINATION IN MARITAL & FAMILY THERAPY

APPLICATION FOR NATIONAL EXAMINATION IN MARITAL & FAMILY THERAPY Minnesota Board of Marriage and Family Therapy 2829 University Avenue SE, Suite 400 Minneapolis, MN 55414-3222 Telephone: (612) 617-2220 Fax: (612) 617-2221 Email: mft.board@state.mn.us Website: www.bmft.state.mn.us

More information

1. YOU MUST AMEND YOUR CORPORATE AUTHORIZATION WITHIN 30 DAYS OF EFFECTIVE DATE OF THE CHANGE. FILL OUT THE AMENDMENT APPLICATION, INCLUDE THE $75.

1. YOU MUST AMEND YOUR CORPORATE AUTHORIZATION WITHIN 30 DAYS OF EFFECTIVE DATE OF THE CHANGE. FILL OUT THE AMENDMENT APPLICATION, INCLUDE THE $75. State of Alaska Department of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing Board of Registration for Architects, Engineers and Land Surveyors

More information

INTERNAL SERVICES DEPARTMENT SMALL BUSINESS DEVELOPMENT SMALL BUSINESS CERTIFICATION APPLICATION

INTERNAL SERVICES DEPARTMENT SMALL BUSINESS DEVELOPMENT SMALL BUSINESS CERTIFICATION APPLICATION INTERNAL SERVICES DEPARTMENT SMALL BUSINESS DEVELOPMENT SMALL BUSINESS CERTIFICATION APPLICATION BUSINESS OWNER S DETAILED PERSONAL FINANCIAL STATEMENT (Attachment A) PERSONAL FINANCIAL STATEMENT AFFIDAVIT

More information

30 Day Limited Permits for Professional Engineers and Land Surveyors

30 Day Limited Permits for Professional Engineers and Land Surveyors THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234 Office of the Professions, State Board for Engineering and Land Surveying PHONE: 518-474-3817 ext. 140 FAX: 518-473-6282

More information

NORTH CAROLINA DEPARTMENT OF INSURANCE RALEIGH, NORTH CAROLINA INDIVIDUAL EMPLOYERS SELF-INSURED FOR WORKERS COMPENSATION APPLICATION TO SELF-INSURE

NORTH CAROLINA DEPARTMENT OF INSURANCE RALEIGH, NORTH CAROLINA INDIVIDUAL EMPLOYERS SELF-INSURED FOR WORKERS COMPENSATION APPLICATION TO SELF-INSURE NORTH CAROLINA DEPARTMENT OF INSURANCE RALEIGH, NORTH CAROLINA INDIVIDUAL EMPLOYERS SELF-INSURED FOR WORKERS COMPENSATION APPLICATION TO SELF-INSURE The undersigned, an employer subject to the current

More information

INSTRUCTION SHEET COLLECTION AGENCY

INSTRUCTION SHEET COLLECTION AGENCY INSTRUCTION SHEET In order for your application to be processed, ALL REQUIRED SUPPORTING DOCUMENTATION MUST BE SUBMITTED with the application and required fee unless otherwise directed in the instructions.

More information

The Private Vocational Schools Regulations, 2014

The Private Vocational Schools Regulations, 2014 PRIVATE VOCATIONAL SCHOOLS, 2014 P-26.2 REG 2 1 The Private Vocational Schools Regulations, 2014 being Chapter P-26.2 Reg 2 (effective November 20, 2014). NOTE: This consolidation is not official. Amendments

More information

Licensed Clinical Professional Art Therapist LICENSURE APPLICATION INSTRUCTIONS

Licensed Clinical Professional Art Therapist LICENSURE APPLICATION INSTRUCTIONS MARYLAND BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS Licensed Clinical Professional Art Therapist LICENSURE APPLICATION INSTRUCTIONS *The Application must be on a form currently in use by the Board.

More information

STATE OF CONNECTICUT INSURANCE DEPARTMENT

STATE OF CONNECTICUT INSURANCE DEPARTMENT STATE OF CONNECTICUT INSURANCE DEPARTMENT Fraud, Licensee Investigations and Compliance Unit P.O. Box 816 Hartford, CT 06142-0816 APPLICATION FOR LIFE SETTLEMENT PROVIDER LICENSE General Instructions:

More information

BROKER LICENSE INDIVIDUAL REQUIREMENTS. The following are the basic requirements an applicant must satisfy to obtain a broker license:

BROKER LICENSE INDIVIDUAL REQUIREMENTS. The following are the basic requirements an applicant must satisfy to obtain a broker license: COMMONWEALTH OF PENNSYLVANIA INSURANCE DEPARTMENT BUREAU OF PRODUCER LICENSING 1300 Strawberry Square Phone (717) 787-3840 Harrisburg, PA 17120 Fax (717) 787-8553 BROKER LICENSE INDIVIDUAL REQUIREMENTS

More information

(For Department Use Only) TYPE OF APPLICATION

(For Department Use Only) TYPE OF APPLICATION DEPARTMENT OF COMMERCE Division of Financial Institutions 85 7th Place East, Suite 500 St. Paul, Minnesota 55101 (651) 539-1700 CREDIT SERVICES ORGANIZATION REGISTRATION APPLICATION REGISTRATION NUMBER

More information

AUTHORIZATION TO MAKE REVERSE MORTGAGE LOANS

AUTHORIZATION TO MAKE REVERSE MORTGAGE LOANS NC Commissioner of Banks Location: 316 W. Edenton Street, Raleigh, NC 27603 Mail Address: 4309 Mail Service Center, Raleigh, NC 27699-4309 Telephone: 919/733-3016 Fax: 919/733-2978 Internet: www.nccob.gov

More information

Documents Required. $400 due diligence check per company made payable to Capstone Business Funding, LLC

Documents Required. $400 due diligence check per company made payable to Capstone Business Funding, LLC Legal Business Name Date Documents Required Current Accounts Receivable Aging Report Company Information Application and Origination Statement (Have your signature notarized under Origination Statement

More information

Department of Commerce

Department of Commerce Department of Commerce COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS Caller Box 10007 CK, Saipan, MP 96950 Telephone: (670) 664-3064/3000 Fax: (670) 664-3067 Email: commerce@pticom.com Website: www.commerce.gov.mp/

More information

ADAM H. PUTNAM COMMISSIONER

ADAM H. PUTNAM COMMISSIONER FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES ADAM H. PUTNAM COMMISSIONER PROFESSIONAL SOLICITORS REGISTRATION APPLICATION Chapter 496, Florida Statutes 5J7.006 Florida Department of Agriculture

More information

Tax Credit Consultant

Tax Credit Consultant Highlands Housing Authority 215 Shore Drive, Highlands, New Jersey 07732 TELEPHONE: (732) 872-2022 FAX: (732) 291-8743 Request for Proposals Tax Credit Consultant Proposals due by 2:00 PM on March 26,

More information

SAMPLE STATE OF HAWAII STANDARD QUALIFICATION QUESTIONNAIRE FOR OFFERORS. issued by the PROCUREMENT POLICY BOARD STATE OF HAWAII.

SAMPLE STATE OF HAWAII STANDARD QUALIFICATION QUESTIONNAIRE FOR OFFERORS. issued by the PROCUREMENT POLICY BOARD STATE OF HAWAII. SAMPLE STATE OF HAWAII STANDARD QUALIFICATION QUESTIONNAIRE FOR OFFERORS issued by the PROCUREMENT POLICY BOARD STATE OF HAWAII June 16, 2003 To be filed with the procurement officer calling for offers

More information

FORM 628-15 APPLICATION TO BECOME A CERTIFIED INVESTMENT ADVISER INSTRUCTIONS FOR FORM 628-15

FORM 628-15 APPLICATION TO BECOME A CERTIFIED INVESTMENT ADVISER INSTRUCTIONS FOR FORM 628-15 FORM 628-15 APPLICATION TO BECOME A CERTIFIED INVESTMENT ADVISER INSTRUCTIONS FOR FORM 628-15 1. Authority This form must be completed by any investment adviser who wishes to become a certified investment

More information

MAGNOLIA BOARD OF EDUCATION 801 Preston Ave Suite D Somerdale, New Jersey 08083

MAGNOLIA BOARD OF EDUCATION 801 Preston Ave Suite D Somerdale, New Jersey 08083 MAGNOLIA BOARD OF EDUCATION 801 Preston Ave Suite D Somerdale, New Jersey 08083 REQUESTS FOR PROPOSALS SOLICITOR/AUDITOR/ARCHITECT/OCCUPATIONAL THERAPIST NOTICE OF SOLICITATION Notice is hereby given that

More information

ALL CANDIDATES MUST TAKE A PRACTICAL & WRITTEN EXAM

ALL CANDIDATES MUST TAKE A PRACTICAL & WRITTEN EXAM 617-727-9940 Effective May 12, 2009 OUT OF STATE APPLICANTS INSTRUCTION SHEET ALL CANDIDATES MUST TAKE A PRACTICAL & WRITTEN EXAM A COMPLETED APPLICATION MUST INCLUDE: A small 2 x 2 photo Money Oorder

More information

For more information you may contact Jeannette Martínez at (787) 723-8403 or 723-3131 ext. 2305.

For more information you may contact Jeannette Martínez at (787) 723-8403 or 723-3131 ext. 2305. 05/10 Commonwealth of Puerto Rico COMMISSIONER OF FINANCIAL INSTITUTIONS Centro Europa Building, Suite 600 1492 Ponce de León Avenue San Juan, PR 00907-4127 Tel. (787) 723-8403 Fax: (787) 724-2604 INVESTMENT

More information

M E M O R A N D U M. TO: ALL Interior Designer applicants FROM: JEAN WILLIAMS, EXECUTIVE DIRECTOR

M E M O R A N D U M. TO: ALL Interior Designer applicants FROM: JEAN WILLIAMS, EXECUTIVE DIRECTOR M E M O R A N D U M The Board of Governors of the Licensed Architects Landscape Architects and Registered Interior Designers of Oklahoma P. O. Box 53430 Oklahoma City, OK 73152 (405) 949-2383 TO: ALL Interior

More information

CANDIDATE AFFIDAVIT [Art. XXVIII, Sec. 2(2) & 1-45-110(1), C.R.S.]

CANDIDATE AFFIDAVIT [Art. XXVIII, Sec. 2(2) & 1-45-110(1), C.R.S.] Space Below For Office Use Only Municipal Candidates file with the Municipal Clerk CANDIDATE AFFIDAVIT [Art. XXVIII, Sec. 2(2) & 1-45-110(1), C.R.S.] This affidavit shall certify that I,, am a candidate

More information

Sterling High School Board of Education Somerdale, New Jersey

Sterling High School Board of Education Somerdale, New Jersey Notice is hereby given that pursuant to the provisions of N.J.S.A. 19:44A-20, New Jersey Pay to Play, and other legislative enactments, more specifically Chapter 271 of the laws of the State of New Jersey,

More information

Sec. 90-27. Certificates of use.

Sec. 90-27. Certificates of use. Sec. 90-27. Certificates of use. (1) It is hereby deemed unlawful for any person to open or operate any business and/or occupy any structure within the town limits for the privilege of engaging in any

More information

*** All renewal applications must be filed by March 2, 2015 ***

*** All renewal applications must be filed by March 2, 2015 *** REAL ESTATE AND MOBILE HOME TAX RELIEF APPLICATION Office of the Tel.: (804) 652-2161 Fax: (804) 829-6228 2015 Tax ID No.: For Office Use Only Applicant s Name: *** All renewal applications must be filed

More information

TITLE 11 DEPARTMENT OF HEALTH CHAPTER 351 Nursing Student Loan Program

TITLE 11 DEPARTMENT OF HEALTH CHAPTER 351 Nursing Student Loan Program TITLE 11 DEPARTMENT OF HEALTH CHAPTER 351 Nursing Student Loan Program 11-351-1 Purpose 11-351-2 Definitions 11-351-3 Loan management 11-351-4 Loan funds 11-351-5 Purpose of loans 11-351-6 Eligibility

More information

APPLICATION FOR THERAPEUTIC MASSAGE THERAPIST LICENSE

APPLICATION FOR THERAPEUTIC MASSAGE THERAPIST LICENSE APPLICATION FOR THERAPEUTIC MASSAGE THERAPIST LICENSE CITY ADMINISTRATOR S OFFICE 1307 Cloquet Avenue, Cloquet MN 55720 Phone: 218-879-3347 Fax: 218-879-6555 www.ci.cloquet.mn.us email: djohnson@ci.cloquet.mn.us

More information

DEPARTMENT OF COMMERCE DIVISION OF FINANCIAL INSTITUTIONS

DEPARTMENT OF COMMERCE DIVISION OF FINANCIAL INSTITUTIONS STATE OF MINNESOTA DEPARTMENT OF COMMERCE DIVISION OF FINANCIAL INSTITUTIONS RE: CONSUMER SMALL LOAN LENDER ACT Application may be made on the attached forms for a Consumer Small Loan Lending license pursuant

More information

OKLAHOMA MOTOR VEHICLE COMMISSION APPLICATION PACKET FOR DEALER ADDING FRANCHISE LICENSE(S)

OKLAHOMA MOTOR VEHICLE COMMISSION APPLICATION PACKET FOR DEALER ADDING FRANCHISE LICENSE(S) Rev (10-2013) APPLICATION PACKET FOR DEALER ADDING FRANCHISE LICENSE(S) This form only applies to Dealers selling new automobiles, trucks or buses THIS PACKET IS FOR: Automobile, Truck or Bus Dealers adding

More information

SOUTH DAKOTA DIVISION OF INSURANCE 124 S Euclid Ave, 2 ND Floor Pierre, South Dakota 57501 (605) 773-3563 http://dlr.sd.

SOUTH DAKOTA DIVISION OF INSURANCE 124 S Euclid Ave, 2 ND Floor Pierre, South Dakota 57501 (605) 773-3563 http://dlr.sd. SOUTH DAKOTA DIVISION OF INSURANCE 124 S Euclid Ave, 2 ND Floor Pierre, South Dakota 57501 (605) 773-3563 http://dlr.sd.gov/insurance Purchasing Group (PG) Registration To Do The Business of Insurance.

More information

**Additional information may be requested at the discretion of the Board.**

**Additional information may be requested at the discretion of the Board.** Oklahoma State Board of Dentistry 2920 N Lincoln Blvd., Ste. B OKC, OK 73105 (405)522-4844 Oklahoma State Board of Dentistry CHECKLIST- DDS/ SPECIALTY/ RDH BY CREDENTIALS *In order to be eligible for licensure

More information

M E M O R A N D U M. TO: All Interior Designer Candidates. FROM: Jean Williams, Executive Director Oklahoma Board of Architecture

M E M O R A N D U M. TO: All Interior Designer Candidates. FROM: Jean Williams, Executive Director Oklahoma Board of Architecture M E M O R A N D U M TO: All Interior Designer Candidates FROM: Jean Williams, Executive Director Oklahoma Board of Architecture RE: Registration and Testing Application Process This application is for

More information

Revised January 2011. You must submit with the application the following documentation:

Revised January 2011. You must submit with the application the following documentation: Charlie A. Dooley County Executive Sheryl L. Hodges, D.E., P.E., L.P.G. Director MECHANICAL LICENSING Guidelines for completing the Application for Contractor License Contractor License Categories: Mechanical,

More information

GUARANTY BOND SAMPLE. correspondence school seeks from the State Board of Community Colleges licensure to

GUARANTY BOND SAMPLE. correspondence school seeks from the State Board of Community Colleges licensure to Guaranty Bond Page 1 STATE OF NORTH CAROLINA Bond No. COUNTY OF GUARANTY BOND KNOW ALL PERSONS BY THESE PRESENT THAT: WHEREAS, A proprietary business school, or proprietary trade school or proprietary

More information

PINE HILL BOARD OF EDUCATION Pine Hill, New Jersey 08021 REQUESTS FOR PROPOSALS OCCUPATIONAL THERAPY SERVICES NOTICE OF SOLICITATION

PINE HILL BOARD OF EDUCATION Pine Hill, New Jersey 08021 REQUESTS FOR PROPOSALS OCCUPATIONAL THERAPY SERVICES NOTICE OF SOLICITATION PINE HILL BOARD OF EDUCATION Pine Hill, New Jersey 08021 REQUESTS FOR PROPOSALS OCCUPATIONAL THERAPY SERVICES NOTICE OF SOLICITATION Notice is hereby given that pursuant to the provisions of N.J.S.A. 19:44A-20,

More information

State of New Jersey Department of Banking & Insurance. Annual Report Worksheet for Residential Mortgage Brokers. Year Ending December 31, 2013

State of New Jersey Department of Banking & Insurance. Annual Report Worksheet for Residential Mortgage Brokers. Year Ending December 31, 2013 State of New Jersey Department of Banking & Insurance for Residential Mortgage Brokers New Jersey Department of Banking & Insurance Division of Banking Attn: Kristen Graham -- 5 th floor 20 West State

More information

BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF:

BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF: BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF: DATE SUBMITTED: FOR CONSIDERATION BY THE DALLAS COUNTY BAIL BOND BOARD ** please provide one original and one redacted copy ** DALLAS COUNTY BAIL

More information

REQUEST FOR QUALIFICATIONS FOR CONSTRUCTION MANAGER-AT-RISK (CMAR)

REQUEST FOR QUALIFICATIONS FOR CONSTRUCTION MANAGER-AT-RISK (CMAR) REQUEST FOR QUALIFICATIONS FOR CONSTRUCTION MANAGER-AT-RISK (CMAR) For the Project: CITY OF KATY NEW KATY FIRE STATION #2 Issued: August 13, 2015 Katy Fire Station #2 August 13, 2015 Page 1 of 17 Request

More information

Application for Consumer Finance License

Application for Consumer Finance License NC Office of the Commissioner of Banks Location: 316 W. Edenton Street, Raleigh, NC 27603 Mail Address: 4309 Mail Service Center, Raleigh, NC 27699-4309 Telephone: 919/733-3016 Fax: 919/733-6918 Internet:

More information