American Compulsive
Gambling
Counselor Certification Board
3635 Quakerbridge Road, Suite 7
University Office Plaza 1
Hamilton, NJ 08619
Ph. (609) 588-9338
www.certificationboard.com
CCGNJShirl@aol.com
Application Process Fee Structure
The following fees have been established for Initial Certification:
Application fee (must be submitted with form below)
$ 50.00
and prior to registering for the written exam
Review fee
$ 50.00
Certification fee upon approval of application by the ACGCCB) $100.00
Testing Fee (Varies) $
ALL FEES ARE NON-REFUNDABLE
Checks should be made payable to: ACGCCB
To receive an application form, please mail your check for the initial application fee,
along with the completed form below, to:
American Compulsive Gambling Counselor Certification Board
3635 Quakerbridge Road, Suite 7
Hamilton, New Jersey 08619
Attention: Shirley Ray
Upon receipt of your check, an application will be forwarded to you.
Any questions concerning the application process should be directed to the above address,
or to (609) 588-9338.
APPLICATION REQUEST FORM
American Compulsive Gambling Counselor Certification Board
3635 Quakerbridge Road, Suite 7
Hamilton, New Jersey 08619
** Please Note: This form will not be accepted unless typewritten. You may
also either
contact the Board for a floppy disk or cut and paste the required text into a
Word document and complete.
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