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Initial Certification Application Packet

This is the entire package of materials required for initial certification of an alcohol and/or other drug program. Please print out and/or save every document below. You will need to refer to them often. The documents may be downloaded in Microsoft Word or PDF format.

If you have access to Microsoft Word '97 or a newer version of Microsoft Word, you will be able to fill out the majority of all required form fields electronically. You will also be able to save a completed version (with your organization's information) of the document locally. After doing so, the completed application can be printed from Microsoft Word, additional fields (eg. signatures) can be completed manually, and the complete application can be sent to ADP. It is not recommended that you view or complete the Microsoft Word application documents within your Internet browser window. Please download or save these documents first and then open them in Microsoft Word.

If you do not have access to a compatible version of Microsoft Word, you may download the application documents in Adobe's .pdf format. This format cannot be electronically completed. Adobe .pdf users must first print out the application and then complete it manually. To access the PDF format you need Acrobat Reader on your computer. If you do not have Acrobat Reader on your computer, click here to download and install Acrobat Reader for free on your computer.

After reviewing all of these documents, print and complete all applicable forms and submit a hard copy to the Department of Alcohol and Drug Programs, Licensing and Certification Division, 1700 K Street, Sacramento, California 95811-4037. Retain a copy of all information submitted to the Department for your files.