Certification File Review - Residency Program Administrator

Signed and dated OSPI Forms
  • Application Form (4201)
  • Character and Fitness Supplement Form (4020B), if applicable
  • Verification of Good Standing in Other States (4020C), if applicable
  • Fingerprint clearance within two years of being placed on the recommending list
  • Master's degree conferred from accredited program
  • Evidence of certification fees paid
Revised 7/2012