Pregnant and Parenting Families (PPF) Training
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Sharing of Personal Data for Purposes of Credentialing
The applicant authorizes, agrees and unambiguously consents to the transmission by the Missouri Credentialing Board (MCB) of any personal data information related to legitimate credentialing purposes with the Missouri Credentialing Board (MCB)) affiliate boards. This authorization and consent are freely given by the applicant.
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The applicant authorizes, agrees and unambiguously consents to the transmission by the InternatioThe applicant authorizes, agrees and unambiguously consents to the transmission by the Missouri Credentialing Board (MCB) of any personal data information related to legitimate credentialing purposes with the Missouri Credentialing Board (MCB)) affiliate boards. This authorization and consent are freely given by the applicant.al Certification and Reciprocity Consortium (IC&RC) of any personal data information related to legitimate credentialing purposes with the International Certification & Reciprocity Consortium (ICRC) affiliate boards. This authorization and consent are freely given
by the applicant.
Applicant’s Agreement to the Code of Ethical Practice and Professional Conduct
I have read the Current PPF Ethics Code as listed on the MCB web site, MCB Ethics Code Link and agree to abide by this code:
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AUTHORIZATION AND RELEASE
I hereby certify all of the information given herein is true and complete to the best of my knowledge and belief. I also authorize any relevant investigations, or the release of personal information to the Missouri Credentialing Board, its agents, or contractors pursuant to this application/renewal procedure. I understand falsification of any portion of this application/renewal will result in my being denied credentialing, or revocation of same upon discovery.
I further agree to hold the Missouri Credentialing Board and its Board Members, officers, agents, staff, peer evaluators and examiners, free from any civil liability for damages or complaints by reason of any action that is within the scope and arise out of the performance of their duties which they, or any of them, may take in connection with this application/renewal, any examination, the grades with respect to any examination, and/or the failure of the MCB to issue me said credential or renewal.
This Authorization and Release shall also apply to personal information requested by the Board at any time following credentialing in connection with any investigation concerning allegations that could lead to disciplinary action against me.
Authorization and Release
Your signature authorizes, agrees and unambiguously consents to the transmission by the Missouri Credentialing Board (MCB) of any personal data information related to legitimate credentialing purposes with the Missouri Credentialing Board (MCB)affiliate boards. This authorization and consent are freely given by the applicant.
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I hereby certify all of the information given herein is true and complete to the best of my knowledge and belief. I also authorize any relevant investigations, or the release of personal information to the Missouri Credentialing Board (MCB), its agents, or contractors pursuant to this application/renewal procedure. I understand falsification of any portion of this application/renewal will result in my being denied credentialing, or revocation of same upon discovery. I further agree to hold the Missouri Credentialing Board (MCB)and its Board Members, officers, agents, staff, peer evaluators and examiners, free from any civil liability for damages or complaints by reason of any action that is within the scope and arise out of the performance of their duties which they, or any of them, may take in connection with this application/renewal, any examination, the grades with respect to any examination, and/or the failure of the Missouri Credentialing Board (MCB) to issue me said credential or renewal. This Authorization and Release shall also apply to personal information requested by the Board at any time following credentialing in connection with any investigation concerning allegations that could lead to disciplinary action against me.
Registration
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Cancellation Policy: A participant may cancel a registration at any time, however, cancellations MUST be done at least 1 week prior to the training date to receive a refund of the registration fee or an exchange. Refunds due to a participant cancellation are subject to a $10 processing fee. If a cancellation is made within a week of the training date, no refund will be issued.
If you have any questions, please call 573-616-2300 or e-mail help@missouricb.com as soon as possible.