License Application FormsInstructions for completing and submitting the forms required for licensure appear below. You may also need to submit additional information (for example, examination scores). Please refer to the license requirements link on the left for complete information regarding all requirements you must meet. Note: All forms are in Adobe
Portable Document Format (PDF). To view or print these documents,
you will need to have the free Adobe Reader installed on your
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Form 1 - Application for Licensure & First Registration (intdesform1.pdf; 41K; 4 pages) All applicants for licensure must complete this form and submit it with the $377 licensure and registration fee directly to the Office of the Professions at the mailing address at the end of Form 1. Make checks payable to the New York State Education Department. NOTE: Your cancelled check is your receipt. You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review. Your signature on Form 1 must be notarized by a Notary Public. Address/Name Change Form - Optional (anchange.pdf; 16K; 2 pages) You are required to notify us within 30 days of any name or address changes. Please read the instructions and complete the appropriate sections of this form. Form 2 - Certification of Professional Education - (intdesform2.pdf; 21K; 2 pages) Please note: This form must be
completed and submitted by the educational institution; the
Office of the Professions will not accept Form 2 if it is
submitted by the applicant.
Section I: Complete this section of the form before sending it to your school. Section II: The Registrar must complete the appropriate parts of this section and return the form directly to the Office of the Professions' Division of Professional Licensing Services at the mailing address at the end of the form. The School must attach a transcript showing all courses you completed and the specific degree awarded (if any) to you. Form 4 - Report of Professional Experience - (intdesform4.pdf; 24K; 2 pages) If you have completed experience required for licensure, complete this form and submit it with your Form 1 to the address at the end of the form. Be sure to sign and date item 6. Form 4A - Verification of Experience - (intdesform4a.pdf; 21K, 2 pages) Please note: One of these
forms must be completed and submitted by each employer or client
who can attest to the professional experience for which you are
seeking credit. The Office of the Professions will not accept
this form if submitted by the applicant.
Section I: Complete this section and forward this form to the appropriate employer or client. Section II: The employer or client must complete this section and return the form directly to the Office of the Professions at the mailing address at the end of the form. |