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California form in state verification 2026
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How to use or fill out California Form in State Verification
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your name in the 'APPLICANT NAME' section, including your last, first, and middle names along with your intern number.
- Fill out the 'SUPERVISOR INFORMATION' section. Include the supervisor's last name, address, license type, and license number. Specify the dates of experience being claimed.
- Answer the questions regarding your experience settings by selecting 'Yes' or 'No' for each item listed under 'APPLICANT’S EMPLOYER INFORMATION'.
- In the 'EXPERIENCE INFORMATION' section, indicate how many weeks of supervised experience you are claiming and log your total direct counseling hours.
- Ensure all information is accurate before signing. Have your supervisor initial any changes made on the form.
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experience verification form bbs
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