License 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.

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 computer. Download times and print quality will depend on your connection speed and printer.

Form 1 - Application for Licensure & First Registration ( PDF 38 KB)

All applicants for licensure must complete this form and submit it with the $173 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 ( PDF 20 KB)

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 Education - ( PDF 21 KB)

This form must be completed and submitted by the school. The Office of the Professions will not accept this form if submitted by the applicant.
 
  • Section I: Complete this section of the form before sending it to your school. Be sure to sign and date item 10 and include any fee required by the school.
  • Section II: The school must complete the appropriate parts of this section and return the form directly to the Office of the Professions at the mailing address at the end of the form.

A separate Form 2 must be submitted for each educational program attended that will demonstrate satisfaction of the education requirement. Photocopy this form as needed.

Form 4 - Cerification of Experience - ( PDF 21KB)
A form must be completed and submitted by each employer with whom you are claiming experience. 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. Be sure to sign and date item 7.
  • Section II: The employer 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.
Last Updated: March 30, 2011