Section 24-8-4-2 - Application for Program AdmissionA. Required Application Materials An individual applying for licensure as a Mental Health/Mental Retardation Administrator shall submit to the Division the following:
(1) A completed, notarized Application Form;(2) A completed Verification of Employment Form;(3) Official transcript(s) from an approved educational institution(s) reflecting a master's degree (at least a 30 semester hour program) in Mental Health, Mental Retardation, Alcohol and Substance Abuse, Business Administration, Accounting, Public Policy Administration or a related field;(4) A completed Verification of Experience Form(s) reflecting at least four (4) years of supervised experience in the field of mental health and / or mental retardation, two (2) of which must be in the State of Mississippi and two (2) of which must have been administrative experience;(5) At least three letters of support which meet the specifications indicated in Chapter 3, Section 3, A., (5), p. 7; and,(6) A non-refundable $75.00 Application Fee made payable to the Mississippi Department of Mental Health. Note: This fee includes administrative costs incurred by the Division over the approximate two years it would take a Participant to complete the program of Independent Study and Training, the remainder of the first two-year licensure period once licensure has been attained and the cost of the certificate.
B. Submission of Application Packet(1) Items 1-6, indicated in Chapter 4, Section 2, A., pp. 16-17, should be completed by the appropriate person(s) indicated on the form(s), collected by the Applicant and submitted together in one application packet to the Division.(2) Items 2-5, indicated in Chapter 4, Section 2, A., pp. 16-17, should be sent in sealed envelopes with a signature across the seal that matches the signature on the document inside the envelope. Signatures on the envelopes and forms will be verified by the Division. Item 3, the official transcript, must be submitted in the envelope provided by the approved educational institution when given to the Applicant.(3) If necessary, the official transcript (Item 3) may be submitted to the Division directly by the approved educational institution.(4) An individual may apply for more than one DMH professional certification/licensure (MH/MR Administrator, Mental Retardation Therapist, Mental Health Therapist, etc.); however, each application packet should be submitted separately, including separate official transcripts, application forms, payment of application fees, etc.C. Responsibility for Application(1) The responsibility for submitting a complete application is that of the Applicant.(2) The Review Board will not review incomplete applications. See Chapter 2, Section 2, B., (4), p. 4.24 Miss. Code. R. § 8-4-2