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Application Instruction Forms

PLEASE READ ALL THE INSTRUCTIONS BEFORE PROCEEDING


PLEASE MAIL THE FOLLOWING INFORMATION:

    a) Application Form
    b) Personal Code and Ethical Standards Form
    c) Consent to Release of Information Form
    d) Self Evaluation Forms
    e) Approved Education Hours
    f) Initial Application fee of $100 payable to the: Canadian Problem Gambling Certification Board


Note: Please allow up to 6-8 weeks processing time for approval of your application. The certification board reserves the right to require applicants to pass a written test.


Once you receive written notice of approval for certification, you will be required to pay a final fee of $200. Once your certification fee is processed, you will receive your Canadian Problem Gambling Counsellor designation and certificate.


All Canadian Problem Gambling Counsellors must re-certify every two (2) years to maintain their designation. See recertification requirements.

Please return this application with all the required documentation and your cheque in the amount of $100 to:


Canadian Problem Gambling Certification Board
PO Box 37055 Bella Vista Plaza PO
Windsor, Ontario, N9H 2N8, Canada
Toll Free: 1-877-421-1181, Fax: 519-739-0315