Entry & Associate Certification Renewal Form

This form is composed of several short sections. Each answer will direct you to the next appropriate section. Start with providing your name below, then proceed to complete the items as they appear. The renewal form is divided into 3 sections, Professional Engagement, Continuing Education, and Eligibility. After completion of the items in each section, conclude this portion of the renewal process by proceeding to the payment selection section and SUBMIT.

There is a link in the confirmation page that will take you back to the page you were on before you came to this form. There is a PayPal link that will accept your payment and complete the process.

Please make sure to send in your supporting documents by fax, email attachment, or mail (least preferred). The renewal will not be complete until all of these items are completed,documentation received and approved.

Fax: (979) 764-7307
email: cycoffice@youthworkacademy.org

You will receive an email payment confirmation when you complete the electronic payment process. The CYC Office will send email confirmation when it receives your supporting documentation and a listing of any missing information. Once all required items are received and approved, you will receive an email renewal confirmation.

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question