AA

Instructions

Screen Guide

Demographics

Regulatory Questions

Education Information

Certification of Licensure

List A

List B

Citizenship-U.S. Citizenship or National Status

Citizenship-Declaration

Release

Review Page – If everything is correct, press “Next”

Affirm And Submit

When entering dates attended in the education sections if you do not know the exact date use the first date of the month. (Example: you attended from August 1990 – July 1994, enter 08/01/1990 – 07/01/1994)

  

When entering dates attended in the education sections if you do not know the exact date use the first date of the month. (Example: you attended from August 1990 – July 1994, enter 08/01/1990 – 07/01/1994)

  
Please note that after you click the Submit button, you cannot make changes to your application.

P.O. Box 946 / Montgomery, AL 36101-0946 / (334) 242-4116