844 IAC 21-2-1 Application for license as a behavior analyst

Sec. 1. (a) An applicant for licensure as a behavior analyst shall provide the board with the information required in IC 25-8.5-3-1 and the following: (1) A completed application. (2) The fee required by section 4 of this rule. (3) Demographic information, including: (A) name; (B) date of birth; (C) Social Security number; (D) contact information; (E) citizenship information; (F) military history; (G) employment history; (H) gender; and (I) other states of licensure. (4) Information regarding fitness for practice, including disciplinary, criminal, and substance abuse history. (5) A statement from the appropriate agency in each state where the applicant has been licensed, certifying whether disciplinary proceedings: (A) have ever been initiated; or (B) are presently pending; against the applicant. (b) The committee shall verify with: (1) the BACB, or its successor; or (2) another entity approved by the committee; that the applicant is currently certified in good standing as a BCBA.