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Forms and Publications

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Mold Remediation Worker Registration

Title Document Number
Mold Remediation Worker Initial Registration Application (PDF) MLD-LIC-001
Mold Remediation Worker Registration Renewal Application (PDF) MLD-LIC-002

Mold Assessment Technician License

Title Document Number
Mold Assessment Technician Initial License Application (PDF) MLD-LIC-003
Mold Assessment Technician License Renewal Application (PDF) MLD-LIC-004

Mold Remediation Contractor License

Title Document Number
Mold Remediation Contractor Initial License Application (PDF) MLD-LIC-005
Mold Remediation Contractor Renewal Application (PDF) MLD-LIC-006

Mold Assessment Consultant

Title Document Number
Mold Assessment Consultant Initial License Application (PDF) MLD-LIC-007
Mold Assessment Consultant License Renewal Application (PDF) MLD-LIC-008

Mold Analysis Laboratory

Title Document Number
Mold Analysis Laboratory Initial License Application (PDF) MLD-LIC-009
Mold Analysis Laboratory Renewal License Application (PDF) MLD-LIC-010

Mold Assessment Company License

Title Document Number
Mold Assessment Company Initial License Application (PDF) MLD-LIC-011
Mold Assessment Company License Renewal Application (PDF) MLD-LIC-012

Mold Remediation Company License

Title Document Number
Mold Remediation Company Initial License Application (PDF) MLD-LIC-013
Mold Remediation Company License Renewal Application (PDF) MLD-LIC-014

Mold Training Providers

Title
Mold Training Provider Accreditation Application (PDF)
Mold Training Course Approval (PDF)
Mold Training Roster (PDF)

Consumer Information Documents

Title
Consumer Mold Information Sheet (PDF)
Help! I Have Mold - What Is It? (PDF)

Other Forms

MLD-LIC-015 Certificate of Insurance Form (PDF)

MLD-LIC-016 Mold Company Request for Duplicate License or Change of Contact (PDF)

MLD-LIC-017 Experience Verification Form (PDF)

MLD-LIC-018 Mold Individual Request for Duplicate License/Registration or Change of Contact Information (PDF)

Social Security Number Status Certification

Criminal History Evaluation Letter

Criminal History Questionnaire (PDF)

Disciplinary Action Questionnaire (PDF)

Military Service Member, Military Veteran, or Military Spouse Supplemental Application (PDF) - see Military Spouse Frequently Asked Questions

Request to Executive Director for Expired License Renewal (PDF)

Voluntary License Surrender Form (PDF)