Social Work
LMSW Application Forms
Instructions 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.
Form 1 - Application for Licensure - (lmsw1.pdf; 45K; 4 pages)
All applicants for licensure must complete this form and submit it with the $270 licensure and first 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. Upon receipt of your completed application, we will send you an acknowledgement letter.
Address/Name Change Form - Optional (anchange.pdf; 25K; 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 - (lmsw2.pdf; 28K; 2 pages)
This form must be submitted directly by the educational institution.
Section I: Complete this section of the form before sending it to your educational institution. Be sure to sign and date item 8.
Section II: The Registrar must complete this section and return the form in a school envelope directly to the Office of the Professions at the mailing address on the form.
If you attended a social work program not registered as licensure qualifying by the New York State Education Department or accredited by the CSWE, you must also ask your school to submit an official transcript or marksheets.
Form 3 - Verification of Other Licensure/Certification - (lmsw3.pdf; 25K; 2 pages)
Use this form only if you are or have been licensed/certified in any profession in any jurisdiction.
This form must be submitted directly by the licensing/certifying authority.
Section I: Complete this section of the form before sending it to the licensing/certifying authority of each jurisdiction in which you are or have been licensed/certified. Be sure to sign and date item 8.
Section II: The licensing/certifying authority must complete this section, sign, date and return the form directly to the Office of the Professions at the address at the bottom of the form.
Form 5 - Application for Limited Permit - (lmsw5.pdf; 29K; 2 pages)
Section I: Complete this section before having your prospective supervisor complete Section II. Be sure to sign and date item 9.
Section II: Ask your prospective supervisor to complete this section.
Return the completed form with the $70 fee to the Office of the Professions at the mailing address at the end of the form.
Child Abuse Certification of Exemption Form (form1ce.pdf; 17k; 1 page)
This form is not for all applicants. Use this form only if you are applying for an exemption to the requirement to complete training or coursework in the identification of child abuse and maltreatment because the nature of your practice excludes contact with persons under the age of 18 and persons 18 or older with a handicapping condition who reside in a residential care school or facility.
