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Certified Prevention Specialist/Associate Prevention Specialist Application Form

Certified Prevention Specialist Requirements

Academic Degree and Related

Required Work Experience - (AA or BA-BS/CADC)
1 Year (2000 hours) with major portion of work experience and practice in Prevention & Community activities
Practicum/Supervision

120 Hours supervised Prevention (120 hours specific to the domains and 10 hours minimum in each domain
*****Domains-See Attached “Certified Prevention Specialist- Appendix A-IC&RC Prevention Certification Performance Domains and Job Tasks*****

Education/Workshops

Post degree/post certification (150 hours of prevention specific workshops/seminars or University courses in Prevention and Community work)

Ethics

100 hours of prevention specific education
50 hours must be in alcohol, tobacco & other drug education (ATOD) 6 hours of Prevention Ethics Course (This does not include 3+3, online, or home study)
Signed Code of Ethics/Affirmation Statement verifying applicant read, understands and will adhere to boards Code of Ethics-Prevention Specific

Administrative Prevention Program

Three (3) letters of recommendation from prevention specialist peers. A certified prevention specialist must sign one (1)

Formal Application

All blanks filled out with appropriate information, Current photo attached to Application, and 300 Word Philosophies

Examination

Must Pass IC&RC Prevention Specialist (PS) examination (No test required for APS)

Residency

Live or work 51% on the time within ODAPCA’s Jurisdiction

Professional Reference Forms

Choose 3 Professional References-(Present employing agency, prevention practicum training supervisor, agency, supervisor, peer prevention professional, or chairperson of your agency board of directors)- One (1) must be a CPS, Document Professional References on “professional references” tracking sheet. Have your professional reference mail form back to ODAPCA (Applicant should not mail form)

Employee Verification

Completely fill out three (3) employee verification forms. have employee sign and date form, applicant shall mail form to ODAPCA

Education/Verification

Send “Official Transcript” to ODAPCA (must be sealed and stamped official), fill out workshop tracking sheet with appropriate Continuing Education Units (CEU’s). Mail form to ODAPCA

Practicum/Training Supervision

Practicum/Training Supervision Send Certified Prevention Specialist Practicum/training for to Supervisor, Applicant and Supervisor must sign and date form. Mail form to ODAPCA

General Information

General Information and written exam resources
Credit Card Payment- You will be receiving an email with a secure credit card payment link-ODAPCA does not take any personal credit card information (there will be a administration fee for all credit card payments) Checks-please mail check to 9301 S I-35 Service Rd. Moore, OK 73160 Purchase Orders-please contact Roxanne at 405.793.1545

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