**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1.
Are you licensed as a Psychologist from the Maryland Board of Examiners of Psychologists? (If you respond Yes, please upload a copy with your application)
Yes
No
2.
If yes, please provide your license type, license number and expiration date below.
Department of Budget and Management