NADSP DSP-R Application

Apply for your DSP-R Status

Thank you for your interest in the national DSP-R status from the National Alliance for Direct Support Professionals (NADSP). After you complete this form, you will be directed to a payment page to submit your payment. The application fee for is $50.

For more information about this designation, you can visit our NADSP DSP-R page.

Direct Support Professional Information
Date of Application*
MM slash DD slash YYYY
Name*
First Last
Check Status Level*
- DSP-R (New)
Where should the award be mailed?
- Employer
- DSP
Address*
Street Address 1 Street Address 2 City State / Province Zip / Postal Code
Date of Birth
MM slash DD slash YYYY
Office Phone
Cell Phone
Email*
DSP Employment History
Code of Ethics Commitment*
By checking the box below, I affirm that I have reviewed, understood, and will abide by the NADSP Code of Ethics through the services I provide and all of my interactions with the people I support, those I work with, and other members of the broader community.
- I agree to abide by the Code of Ethics
Please upload any files required through your application:
Please upload your employer letter and statement of professional commitment. The employer letter should document that you have completed all required training, have at least 6 months of continuous employment as a DSP, have no substantiated cases of abuse, neglect or exploitation, and have a criminal background check which meets the standards of your employer. The statement of professional commitment should describe your values, commitment to and purpose in entering the profession.
Drop files here or

Max. file size: 128 MB.
Employer Representative Information
Name of Employer Representative*
First Last
Phone - Employer Representative
Email - Employer Representative*
Employer Information
Name of Employer*
Employer Address
Street Address 1 Street Address 2 City State / Province Zip / Postal Code
Phone
Website
DSP Employment Information
Length of Employment*
Date of Hire
MM slash DD slash YYYY
Continuous Employment?
- Yes
- No
If you selected 'No,' please explain gaps:

NADSP DSP-R Application

Direct Support Professional Information

Employer Representative Information

Employer Information

DSP Employment Information