Mold Professional License Application

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Please fill out the application below to open a Licensed Mold Professional account. This account will allow individual applicants to apply for a license as a Mold Assessor and/or Mold Remediator, as well as carry out the ongoing notification duties required for all mold professionals.

Please allow 2-3 business days for processing. If additional information is needed, applicants will be contacted via email.

License Fees

$300 For Initial Licenses
$105 For Renewal Licenses

Application Required Documents

Passport-type photograph of yourself
Proof of Insurance (General Liability & Errors and Omission)
Proof of passing qualified mold examination
Documented relevant field experience - Employment Verification Form or Proof of Previous Mold Projects
Proof of Education (where applicable-College Graduate)
Proof of Existing Professional (where applicable)

as College Graduate

Copy of Diploma or Degree with thirty semester hours in microbiology, engineering, architecture, industrial hygiene, occupational safety, or a related field of science from an accredited institution and a minimum of one (1) year of documented relevant field experience

as Existing Professional

A certified industrial hygienist, a professional engineer, a professional registered sanitarian, a certified safety professional, or a registered architect, with at least six (6) months of documented relevant field experience

as High School Graduate

A high school diploma or the equivalent with a minimum of three (3) years of documented relevant field experience.

Mold Professional License/Account Application

Preferred Payment Method

Type of License

Type of Application

Business Name (if Applicable)

STEP 1: CONTACT/PERSONAL INFORMATION

First Name

Last Name

Address (House number and street name)

Address 2 (Apt/Condo number)

City

State/Region

Postal Code

Phone Please use the conventional phone number format "202-999-9999"

Date of Birth Please use the following format for Date of Birth "09/20/2000" remember applicants under the age of 18 will be denied.

Gender

e-Mail Address This email will be used as your username for the DOEE Licensed Mold Professional Database

Passport-type photograph of yourself

STEP 2: EDUCATION/RELATED FIELD EXPERIENCE

Choose the educational background here that best reflects your experience.

High School

College

Existing Professional

STEP 3: PROOF OF INSURANCE

Proof of Errors and Omission Insurance
Proof of Errors and Omission Insurance Expiration Date
Proof of General Liability Insurance
Proof of General Liability Insurance Expiration Date

STEP 4: PROOF OF APPROVED EXAM

Submit proof of passing an examination on mold.

STEP 5: AFFIDAVIT AND CLEAN HANDS

FOR INDIVIDUAL DISCIPLINE APPLICANTS ONLY
For the Applicant: The information that I have provided in this form is true, accurate, and complete to the best of my knowledge. I understand that my application is subject to verification, and I agree to provide any additional documentation required to review that application. I also understand that outside sources may be contacted for purposes of verifying the information contained in this application, and I hereby give permission for the disclosure of any information that may be needed to determine the validity of the information that I have provided and/or to determine eligibility for the certification sought. I understand that failure to provide full disclosure of any requested information that may be needed to determine the validity of this application or eligibility for certification may result in the rejection of this application. I also understand that completion of this application does not guarantee lead-based paint certification in the District of Columbia. Further, I understand that if the Department finds that I have made a false statement or misrepresentation material to the issuance, modification, or renewal of a certification, the Department may, after notice and opportunity for hearing, suspend, revoke, modify, or refuse to issue, renew, or restore the certification. The Department may also seek to impose administrative or civil penalties under 20 DCMR § 3213. Finally, I understand that under D.C. Official Code § 22-2405, any person convicted of making false statements shall be fined not more than $1,000, or imprisoned for not more than 180 days, or both. A person commits the offense of making false statements if that person willfully makes a false statement that is in fact material, in writing directly or indirectly to any instrumentality of the District of Columbia Government, under circumstances in which the statement could reasonably be expected to be relied upon as true.
Check if you agree

Has any federal, state or local jurisdiction ever revoked, suspended, modified, or proposed to revoke or suspend, or modified any permit, license, certification, or approval you have held or currently hold, or has any penalty action or fine been assessed against you for failure to comply with the laws and regulations pertaining to mold, asbestos, or lead-based paint?

YES

Please Explain