License Application Forms

Important Notice: If you were ever licensed in New York State STOP. A New York State professional license is valid for life unless it is revoked, annulled, or suspended by the Board of Regents. To practice in New York State your professional license must be registered. If your registration has lapsed and you need to reregister, do not submit a Form 1. Instead, contact us to request a Delayed Registration Application, or by calling 518-474-3817 Ext. 570.

Form 1 - Application for Licensure ( PDF 41 KB)
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 ( 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 Professional Education - ( PDF 21 KB)
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 - ( PDF 24 KB)
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 - ( PDF 21KB)
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.
Last Updated: June 4, 2018