Forms and Applications


APPRENTICE FORMS AND APPLICATIONS
1st Quarter Apprentice Evaluation	Funeral Directing Case Report
2nd Quarter Apprentice Evaluation	Embalming Case Report
3rd Quarter Apprentice Evaluation	Case Report Supplement
4th Quarter Apprentice Evaluation	Form B - Personal Reference
Apprentice Application	Form D - Certification of Completion of Apprenticeship
Apprentice Application Supplement	Preceptor Change Form
Apprentice Work Schedule


CERTIFICATION FORMS
Inactive Certification Form


WEST VIRGINIA LAW EXAMINATION
West Virginia Law Examination Application


COMPLAINTS
Complaint Form

FUNERAL SERVICES AND FACILITY APPLICATIONS
New Funeral Services Director Application
New Facility Application

**RENEWAL APPLICATION FORMS**
Funeral Service Renewal Application	Apprentice Renewal Application
Crematory Operator Renewal Application	Courtesy Card Renewal Application
Main Funeral Home Renewal Application	Branch Funeral Home Renewal Application

CONTINUING EDUCATION FORMS

Attendance Form

Approved 2016 Continuing Education Providers

Continuing Education Provider Application


COURTESY CARD FORMS
Courtesy Card License Verification Form	Courtesy Card Initial Application

RECIPROCITY LICENSE APPLICATION
Reciprocity License Application

CREMATORY FORMS

Crematory Application

Crematory Operator Application

Operator-in-Charge Change Form

Certified Cremation Education Provider

Application for Certified Cremation Education Provider

REINSTATEMENT FORMS
Main Facility Reinstatement Form	Branch Facility Reinstatement Form
Crematory Reinstatement Form	Individual Reinstatement Form
Facility Reinstatement Fees	Individual Reinstatement Fees

Many of our documents require the use of Adobe Acrobat Reader to view and print. Adobe Acrobat Reader is free for download by clicking the icon to the left. To print any of the Acrobat documents, you need to click the printer icon on the Acrobat tool bar instead of the printer icon on the web browser tool bar.