I, the undersigned, hereby make voluntary application to the American Board of Professional Psychology, Inc., for certification as a specialist. I understand that my application is subject to the rules, bylaws, and other governing provisions of the Board (hereinafter called regulations), and I agree to be bound by the regulations of the Board, either as a candidate for issuance of a specialty board certification, or upon issuance of a specialty board certification, as the holder of same. I agree to be bound by the Code of Ethics of the American Psychological Association or the Canadian Psychological Association, as applicable. I agree to disqualification from examination or issuance of a specialty board certification, or forfeiture of any specialty board certification issued to me, in the event that the Board finds me in violation of its rules and regulations. I recognize that the Board may decide that I am not qualified, and I agree to abide by its decision.
I hereby authorize the American Board of Professional Psychology, Inc., to make inquiries as it deems appropriate in connection with this application for a specialty board certification, with any of the individuals, state licensing boards, agencies, organizations, or other such reference sources as may develop in the course of the Board’s investigation of my qualifications to be board certified as a specialist. I agree and invite anyone so contacted by the Board to answer and respond freely, frankly, and without fear of claim of damage by me, and to report to the Board any knowledge which may seem relevant to the inquiry of the Board.
If granted specialty board certification, I agree that ABPP certification is an active credential that requires annual renewal, an associated attestation, and a fee (currently $185/year). In order to remain active and to use the ABPP credential, I also agree to pay all required annual fees assessed by the American Board of Professional Psychology, Inc.