Forms and Applications

**ALL FEES ARE LOCATED IN LAWS TAB, 6 CSR 7 RULE**
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	Apprentice Checklist
	Apprentice Study Material for WV Law Examination


CERTIFICATION FORMS Inactive Certification Form
LICENSEE IN CHARGE CHANGE FORM LIC FORM


WEST VIRGINIA LAW EXAMINATION
West Virginia Law Examination Application


COMPLAINTS
Complaint Form

RENEWAL FORMS

Main Funeral Home	Branch Funeral Home
Crematory	Funeral Service Licensee
Crematory Operator	Courtesy Card
Mortuary Service	Apprentice

INITIAL INDIVIDUAL AND FACILITY APPLICATIONS
FUNERAL SERVICE LICENSE	MAIN FUNERAL HOME
BRANCH FUNERAL HOME	MORTUARY SERVICE

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

CREMATORY INFORMATION
Crematory application	Crematory Operator Application
Certified Cremation Education Provider	Application for Crematory Education Provider
Crematory Renewal Form	Crematory Operator Renewal Form
Crematory Operator In Charge Change Form	Crematory Operator Reinstatement Form

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

INSPECTION FORMS

FUNERAL HOME INSPECTION FORM

CREMATORY INSPECTION FORM

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