21 NCAC 34B .0106          EMBALMER TRAINEE APPLICATION FORM

Applications for registration as an embalmer resident trainee shall be made on forms available on the Board's website at ncbfs.org. Applications not completed within thirty (30) days following submission to the Board shall be denied. All applications for registration as a funeral service resident trainee shall contain the following:

(1)           The applicant's full name, date of birth, place of birth, and social security number;

(2)           The applicant's email address, residential address, and phone number(s);

(3)           The high school from which the applicant graduated and the date of graduation and a copy of an original certified transcript attesting to the applicant's graduation from high school;

(4)           Whether the applicant attended a mortuary science college and, if so, the name of the mortuary science college, dates of attendance, date of graduation if any, and how many semester hours the applicant completed;

(5)           Whether the applicant has taken the National Board Examination – Arts and, if so, the date on which the examination was taken and whether the applicant passed the examination;

(6)           Whether the applicant has taken the National Board Examination – Sciences and, if so, the date on which the examination was taken and whether the applicant passed the examination;

(7)           The name, address, licensed manager, mailing address, email address, telephone number, and facsimile number of the funeral establishment at which the applicant's traineeship will be performed;

(8)           The applicant's employment history over the preceding five years, to include the name and address of the employer, the dates of employment, and the nature of the work performed;

(9)           Whether the applicant has ever been certified, licensed, or registered to practice funeral service by the Board or by another occupational licensing board and, if so, the type of credential, the jurisdiction of issuance, the issuance date, the expiration date, and any examinations taken to obtain the credential;

(10)         Whether the applicant ever has been denied a credential in another state and, if so, the jurisdiction and the reason for the denial of the credential;

(11)         Whether the applicant has been convicted of a felony or misdemeanor crime and, if so, a statement providing the jurisdiction, charge, date of disposition, and sentence imposed of each conviction;

(12)         Whether the applicant has any criminal charges currently pending and, if so, the nature of the charge and the jurisdiction in which the charge is pending;

(13)         Whether the applicant has had an occupational or business license suspended or revoked by any local, state, or federal agency and, if so, a statement providing the reason for the action and the date, location, and circumstances of any violation that led to action against the license;

(14)         Whether any court, board, agency, or professional organization has found applicant guilty of misconduct, unprofessional conduct, dishonest or fraudulent practice, or incompetent practice and, if so, the tribunal and the date of the finding;

(15)         Whether the applicant has any charges pending before any court, board, agency, or professional organization for unprofessional conduct, dishonest or fraudulent practice, or incompetent practice and, if so, the tribunal in which the charge is pending;

(16)         The applicant's notarized signature to certify that:

(A)          he or she has prepared the application and has read the answers;

(B)          the information provided in the application is true;

(C)          he or she understands that the Board may make inquiries about the applicant, including criminal record checks, and any of the information given in support of the application; and

(D)          he or she understands that any credential issued shall be governed by the provisions of Article 13A, Chapter 90 of the North Carolina General Statutes and the rules promulgated by the Board.

(17)         The proposed supervisor's attestation that:

(A)          he or she is a duly licensed funeral service licensee in North Carolina;

(B)          he or she is employed by the establishment at which the traineeship will occur;

(C)          he or she has been licensed for at least one (1) year and has not had any disciplinary action taken against his or her credential to practice funeral service within the previous five (5) years; and

(D)          he or she will notify the Board when the applicant ceases training under the proposed supervisor;

(18)         The application fee, as prescribed by G.S. 90-210.28 and 21 NCAC 34A .0201. If the application fee is dishonored by the licensee's drawee bank for any reason, the Board shall suspend the license until the renewal fees and non-sufficient fund charges are paid; and

(19)         a photograph of the applicant that is two inches by two inches in size, depicting the applicant facing the camera and without digital alteration.

History Note:        Authority G.S. 90‑210.23(a); 90‑210.25(a)(4);

Eff. February 1, 1976;

Readopted Eff. September 27, 1977;

Amended Eff. November 1, 2004;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 19, 2017;

Temporary Amendment Eff. November 7, 2025.