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Online Request For Certification

To expedite the processing of your Requst For Certification, please enter your information this form and press the submit button at the bottom.   Our administrators will begin processing your request immediately.
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Download Request For Certification

This form is required to initiate the certification process.  NOTE: alternate Online Request For Certification form
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Download Reference Check Form

Two (2) personal reference checks are required to become certified.
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Download W9 Form

Federal W9 form for independent contractor tax purposes
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Funding for this program provided by the Department of Health and Human Services

It is explicitly understood by all parties that the Provider or Vendor is an independent contractor only and not an employee of Woodfords, the Children’s Center, UCP or DHHS