Experience Verification Form Bbs, Degree Program Certification Form (Out-of-State) 3. Gavin Governor This form is to be completed by the applicant’s California supervisor and submitted by the applicant with their Application for Licensure. gov> This form is to be completed by the applicant’s California supervisor and submitted by the applicant with his or her Application for Licensure and Examination. TrackYourHours was updated so when you generate an Experience Verification Form the new form will be populated for any hours logged on or after January 1, 2010 (the BBS is retaining the pre-2010 form). All information on this form is subject to verification. If you cannot provide a copy of the processed Request for Live Scan Service form from your employer, your experience hours will only count from the date your Associate registration is issued. Supervised post-degree work experience must total at least two years (104 weeks) and 3,200 hours. The experience verification forms have only one minor change on page 1. All information on this form is The Clinical Social Experience Verification form is an essential document required by the State of California, Business, Consumer Services, and Housing Agency, IN-STATE Experience Verification This form is to be completed by the applicant’s California supervisor and submitted by the applicant with their Application for Licensure. MARRIAGE AND FAMILY THERAPIST IN-STATE Experience Verification Gavin Governor This form is to be completed by the applicant’s California supervisor and submitted by the applicant with their Application for Licensure.

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