Cannabis Dispensary Agent Training (CDAT) Application

Please review the CDAT Application Guidance before submitting this form. After form submission, no further changes to the materials are permitted during the review process unless they are specifically requested by MMCC. An applicant must provide any additional information requested by MMCC during the review process within 30 days. Failure to do so may result in the denial of an application. Applicants should anticipate at least 90 days for formal consideration of an application.

The non-refundable $200 application fee (Exhibit B) must be paid in the form of a cashier's check or money order made payable to the "Maryland Medical Cannabis Commission" and mailed to: Maryland Medical Cannabis Commission, Attn: Finance and Registrations, 849 International Drive, 4th Floor, Linthicum, MD 21090.

Business Information

Applicant's legal business name

Documentation supporting the applicant business is in good standing (upload incorporation and/or other relevant documents)

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Is this a renewal application?

CDAT Designation Number (assigned by MMCC)

Federal Tax Payer ID (FEIN)

Business Website Address

Business Phone Number

List all Trade Names or DBA names used by the business entity

If business entity is approved by other state cannabis programs to conduct training, please provide links to those approvals here

Primary Point of Contact

Name of Primary Point of Contact

Email Address

Phone Number

Required Documentation

All uploads must be clearly labeled with Exhibit and Name, e.g., Exhibit B "Application Fee"

Exhibit B "Application Fee" (upload photocopy or scan of $200 cashier’s check or money order, as required in Table 1, Exhibit B)

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Exhibit C "Owners" (upload a list of owners and signed Conflict-of-Interest Attestation from each owner, as required in Table 1, Exhibit C)

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Exhibit D "Key Personnel" (upload all detail for each Key Personnel, as required in Table 1, Exhibit D)

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Exhibit E "Course Outline" (upload all detail for Course Outline, as required in Table 1, Exhibit E)

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Exhibit F "Electronic Training Materials for each COMAR 10.62.26.07 core element" (upload all materials as required in Table 1, Exhibit F)

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Exhibit G "Testing Methods and Materials" (upload all materials, as required in Table 1, Exhibit G)

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Renewal Applications Only: Exhibit H "Renewal Application Materials" (upload all materials as required in Table 1, Exhibit H)

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I acknowledge and agree to the following:1) No owner or employee of the CDAT applicant has employment by or interest in a Maryland Medical Cannabis licensee or registrant, 2) Curriculum materials must be current and must be updated within 30 days of rule changes, and 3) Records will be kept for a minimum of four (4) years and provided upon request

I acknowledge and agree (enter full name below)

Attestation:

First Name

Last Name

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I attest to the following: BY CHECKING THIS BOX, APPLICANT ATTESTS THAT NO OWNER, MANAGER, OR EMPLOYEE OF THE CANNABIS DISPENSARY AGENT TRAINING SUBMITTED IS A PERSON OR ENTITY HAVING EMPLOYMENT BY OR INTEREST IN A MARYLAND MEDICAL CANNABIS LICENSEE OR REGISTRANT. I UNDERSTAND THAT THIS ATTESTATION IS MATERIAL TO THE APPLICATION AND THE APPLICATION MAY BE DENIED OR THE APPLICATION MAY BE REVOKED IF THIS ATTESTATION IS FOUND TO BE UNTRUE.