OKLAHOMA BOARD OF PRIVATE VOCATIONAL SCHOOLS



OKLAHOMA BOARD OF PRIVATE VOCATIONAL SCHOOLS

APPLICATION FOR PRIVATE SCHOOL SOLICITOR LICENSE

Purpose of Submission, select one: Re-licensing for FY-      -OR-

New Solicitor (meaning the Solicitor is new to a Main -OR- Branch School/Seminar)

A Solicitor must apply separately and pay a separate fee for each Main and Branch position.

Date:      

1. School/Seminar Name:      

School/Seminar is more than 1-year old. The correct fee is $100/person.

School/Seminar is 1-year old or less. The correct fee is $200/person.

2. SOLICITOR INFORMATION: Name:      

*SS #:       Phone Number: (     )     

* - Must be provided for mandatory Tax Commission searches, per Oklahoma State Statutes.

Permanent (Residence) Address of Solicitor:

     

Street Address

                 

City State Zip Code

OTHER POSSIBLE REQUIRED FORMS

Mandatory, Supplemental Qualification Information (Form 1155CM): Attach Form.

An Affidavit Verifying Citizenship or Alien Status (Form 1190CM):

Is attached for a New Solicitor to the School or Seminar, or a Solicitor if not previously submitted.

Was previously submitted by the School or Seminar for the Solicitor now applying to Re-License.

I hereby certify the information appearing on this Application for Private Solicitor License (Form 1180CM) to be true and correct. I have read and understand the Rules of the Oklahoma Board of Private Vocational Schools (OBPVS) and agree to conduct my personal and business affairs in such a manner as to reflect honesty, integrity, and character in keeping with the intent and purpose of these Rules and the Oklahoma Statutes Title 70 § 21-101 et seq. Should my employment with the School/Seminar be canceled for any reason, I hereby agree to immediately return the Solicitor's License card to the School/Seminar for return to the Board. I realize any infraction of the Board's Rules or the Statutes may cause cancellation of my Solicitor’s License to do business in the State of Oklahoma.

Solicitor's Signature:     

Attach two, recent 1" by 1" headshot photos (face & shoulders) of solicitor below. Or, identify photos and place in an envelope to attach the envelope to the Application.

| |

|Attach photo via |

|Paperclip or staple |

|here |

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|Attach photo via |

|Paperclip or staple |

|here |

PRECAUTIONS: Do not submit photos larger than 1" by 1" or glue or tape photos down.

The OBPVS may require sub-standard photos to be replaced!

3. SCHOOL/SEMINAR INFORMATION:

     

Street Address

                 

City State Zip Code

4. SCHOOL/SEMINAR CERTIFICATION:

I certify that the School/Seminar has screened the applicant and feel that this person will conduct his/her self in accordance with policies and procedures established by the School/Seminar and the Rules of the Oklahoma Board of Private Vocational Schools.

I understand that the School/Seminar is responsible for the actions of the Solicitor/Representative and may be subject to fines and/or revocation of the School's/Seminar's License if the person is found to have violated Oklahoma Statutes Title 70, § 21-101 et seq. and/or the Rules of the Oklahoma Board of Private Vocational Schools (OAC 565:1 or OAC 565:10).

I further certify that this School/Seminar will suspend its employment contract with said Solicitor in the State of Oklahoma at such time as his/her conduct may violate the regulations described in the above paragraph. In the event employment with the Solicitor is canceled or terminated for any reason, I agree that the School or Seminar will use its best efforts to secure the Solicitor’s License and return it to the Oklahoma Board of Private Vocational Schools along with information indicating date and reason for the termination.

|_______________________________________________ |      |

|Signature of the Authorized Administrative Official |Date |

|      |

|Type or clearly print Name |

3. NON-REFUNDABLE FEE.

Contact the OBPVS to confirm the correct Fee due.

Many Schools and Seminars try to overpay the necessary Fee!

Fees are non-Refundable in accordance with OAC 565:10-5-5.

The correct Fee depends on the age of the School or Seminar NOT how long the Solicitor has been employed!

Fee enclosed:

$100.00 - Applies after the first year of the School's or Seminar's OBPVS License.

$200.00 - Applies ONLY until the School/Seminar has been licensed for one year by the OBPVS.

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