This is your application to take the Texas exam administered by the CGC. Texas certification is not automatic
upon successful completion of the exam - please refer to “Applying for TX Certification” on the CGC home page.
$175 application and exam fee for the Texas Exam
($175 Re-testing fee) ($50.00 non-refundable application fee)
APPLICATION DEADLINE IS 30 BUSINESS DAYS PRIOR TO SCHEDULED EXAM DATE!
Exam Location:
Exam Date:
Full Name
(as you wish it to appear on your certificate)
Last Four Digits of Credit Card You Are Using to Pay
Business/Firm Name:
Mailing Address:
City: State: Zip:
Work Telephone:
Fax Number:
Home Telephone:
Email Address:
List your experience providing guardianship or other alternative protective services of person or estate for
the last two years, beginning with the most recent. (optional)
Employer Name/Address
Position
Start and end dates
Have you ever been convicted or pled guilty or no contest to a felony?
Yes
No
Have you ever been found civilly liable for an action of fraud, moral turpitude, misrepresentation, material
omission, misappropriation, theft, or conversion? If yes, please submit a letter of explanation, including the case number.
Yes
No
Have you ever been relieved of responsibilities as a guardian or conservator by a court, employer, or client
for actions involving fraud, misrepresentation, material omission, misappropriation, theft, or conversion? If yes, please submit a letter explaining the circumstances.
Yes
No
Are you bonded in accordance with Texas Statutes and local practice?
Yes
No
If no, please explain.
Have you ever been found liable in a subrogation action by an insurance or bonding agent?
Yes
No
If yes, please explain.
Do you have any special needs requiring CGC attention? Yes No
If yes, please explain.
Please download the Texas Certification Application. Complete and sign the National Certified Guardian Declaration and Agreement. Fax to 717-238-9985.
