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Wv dhhr form ew 212 2026
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- Click ‘Get Form’ to open the wv dhhr form ew 212 in the editor.
- Begin by entering the Application Date and Date of Birth in the specified fields. Ensure these are formatted as mm/dd/yy.
- Fill in your First Name, Last Name, Middle Initial, and Suffix. Provide your Home Phone number and complete your Home Address, including City, State, Zip, and County.
- Indicate if this is a new address by selecting 'Yes' or 'No'. Remember, this address will be used for mailing certification information.
- Enter your Certification Number and Email address. Also, provide the Certification Expiration Date.
- Select the type of certification you wish to renew by checking the appropriate box. Be mindful of any associated fees.
- List course information below and attach copies of completion certificates. If more space is needed, add additional information as necessary.
- Finally, review all entered information for accuracy before signing and dating the form at the bottom.
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