24 MAC Pt. 3, R. 11.2
CCSS (Full Certification) Application
Cite as 24 Miss. Admin. Code Pt. 3, R. 11.2
CCSS (Full Certification) Application
A. To apply for full certification as a CCSS, an individual should submit an o n l in e application
(initial or upgrade) which, at a minimum, contains the following:
1. CCSS Application Form;
2. CCSS Verification of Employment Form;
3. CCSS Verification of Work Experience Form; and,
4. Web-based Training Record - A CCSS applicant must include a signed copy of
his/her web-based training learner transcript in the CCSS application packet.
a. The learner transcript, containing the CCSS applicant’s original signature, must
be signed in blue ink, attesting to the fact that the entire web-based training
component was completed by the applicant. The learner transcript must be
submitted in the appropriate format, as prescribed by the Division.
b. The submitted learner transcript must contain the course names and
corresponding dates of completion for each course in the web-based training
component, as well as the total number of course hours completed.
c. This documentation must be submitted whether the web-based training was
completed through DMH or through an outside venue. Submission of this
information is the applicant’s responsibility.
B. If the CCSS applicant is submitting an initial (not upgrade) application, the following
additional CCSS application component(s) are also required:
1. Official Transcript – (If upgrading from PCCSS, no additional transcript is required.);
and,
2. Application Fee - $40.00 fee (If upgrading from PCCSS, no application fee is
required.) Only individuals applying directly for CCSS pay the application fee. This
is a ONE TIME fee; applicants should not pay the application fee twice.
C. Application forms and application components (i.e., educational escripts and fees) are
submitted online as prescribed by the Mississippi Department of Mental Health via the
agency (DMH) website.