I hereby certify that the statements contained in this application and supporting documents, given for consideration of my application for certification as a PS I or PSII are, to the best of my knowledge, true and correct. I acknowledge that application fees are non-refundable. I further certify that I have read and subscribe to and abide by the WVCBAPP Code of Ethics, based on the IC and RC code of ethics. I authorize the Board to conduct inquiries or interviews as they deem necessary.

I hereby certify that the statements contained in this application and supporting documents, given for consideration of my supervisee's application for certification as an Prevention Specialist I or II are, to the best of my knowledge, true and correct