Work Authorization Application Form

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Please complete thoroughly. Applicants must have earned a master's degree in a field related to school psychology and must hold a current Kansas license in the related field. Inquiries can be sent to KASPApply@gmail.com.

Name *

First and last name

Email (gmail account) *

Phone number *

Address *

Institution From Which You Received Your Master's Degree *

Field In Which You Earned Your Master's Degree

Year in Which You Earned Your Master's Degree

Type of Kansas License You Currently Hold (Special Education, Clinical Psychologist, Social Worker, etc.)

Have you ever had a professional license suspended or revoked?

Yes

Clear selection

Have you ever be investigated for ethics violations?

Yes

Clear selection

Submit

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