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Kentucky Board of Embalmers and Funeral Directors

Kentucky Board of Embalmers & Funeral Directors Forms

The forms are available below for your convenience.  Please note that the forms have open fields where you can enter your information then print out and send to the Board office.  Handwritten forms are not acceptable. 

Forms

  • 2014 Establishment Renewal 667KB | application/pdf

    Establishment renewal license for fiscal year 2014-2015.

  • 2014 Individual Renewal Form 651KB | application/pdf

    Individual license renewal form for funeral directors and embalmers for the fiscal year 2014-2015.

  • Application for Establishment Name Change 249KB | application/pdf

    This form is to be filled out when owners would like to change the name of their establishment.

  • Apprentice Travel Form 96KB | application/pdf

    This form is to be used by apprentices that travel to other Funeral Homes to complete extra cases.

  • Apprenticeship Registration Form 284KB | application/pdf

    Registration form for apprentices to set up their apprenticeship with a funeral home.

  • Apprenticeship Sworn Statement 656KB | application/pdf

    The apprentices must file this document as their sworn statement that they are working and keeping track of all of their cases of removals, funerals and embalmings. Must be filed with the Board office every six months the first of November and May.

  • Change of Supervisor Form 70KB | application/pdf

    This form is to be filled out and sent in when the supervisor of record changes for the registered apprentice.

  • Courtesy Card Application 816KB | application/pdf

    The Courtesy Card Application is used for Funeral Directors in those surrounding states that have reciprocal laws with the Commonwealth of Kentucky regarding Courtesy Cards. The Courtesy Card would allow the applicant to conduct funeral services without going through a licensed Kentucky funeral establishment.

  • Embalmer Exam Application 146KB | application/pdf

    This is the Embalmer exam application for apprentices and reciprocal applicants to fill out.

  • Funeral Director Exam Application 147KB | application/pdf

    This is the Funeral Director exam application for apprentices and reciprocal applicants to fill out.

  • Kentucky C.E. Reporting Form 7KB | application/pdf

    Kentucky continuing education reporting form to be filed with the board office.

  • Level II Apprentice Application 250KB | application/pdf

    This form is to be filled out by apprentices seeking to apply for a Level II apprenticeship program. This is only available to apprentices that have served six months and have completed at least 25 removals, 25 funerals and 25 embalmings.

  • Medical Exemption Form 95KB | application/pdf

    This form is to be filled out if you have a certain medical exemption that would keep you from being able to obtain continuing education. The approval of this form will enable the licensee to keep their license.

  • New Establishment Application 374KB | application/pdf

    This application is for new funeral homes. It is also used for change of ownership.

  • Reciprocal Applications 292KB | application/pdf

    Applications to be filled out by individuals seeking to apply for a reciprocal license.

  • Seventy and Inactive Form 260KB | application/pdf

    This form is for those individuals that no longer practice funeral directing and embalming. Approval of this form enables the individual to be exempt from continuing education and still keep their license.

  • Sponsor Continuing Education Form 263KB | application/pdf

    This form is to be filled out by the sponsors applying to have their continuing education programs approved by the Board.

Download Adobe
 

Note: The following documents are in Adobe Acrobat (.PDF) format.

Please click on the following link to download a free copy of Adobe Acrobat Reader. External Link - You are now leaving the .gov domain.

 

Last Updated 4/9/2012
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