Applicant Forms

Forms for applicants seeking licensure.

Permit Application 

Shared Residency Permit Application

Verification of Employment

State Exam application

Mentor Evaluation of ALDIR/ALD Mentee

Mentor Form Agreement

Permit Request Form (Complete when changing application type and you need to request a permit).

Name Change/Correction Form

Lost License and Replacement License

Online Portal Technical Support Request

Request to Add or Update a Facility