License Application Forms
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- Form 1 - Application for Licensure ( 25 KB)
Important Notice: 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 our customer services unit to request a Delayed Registration Application by e-mailing: email@example.com, or by calling 518-474-3817 Ext. 570. When e-mailing, be sure to include your profession, license number, address on record, new address (if changed), date of birth and the last 4 digits of your SSN.
- All applicants for licensure must complete
this form and submit it with the appropriate fee ($377 for
licensure and first registration, $70 for eligibility to
take Part 1 of the exam only,) directly to the Office of
the Professions at the 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 ( 22 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 ( 20 KB)
- This form must be submitted directly by the educational
institution(s) you attended. The Office of the Professions
will not accept this form if submitted by the applicant.
You must at least document your high school graduation.
- Section l: Complete this section of the form before sending the entire form to your school. Be sure to sign and date item 10.
- Section ll: The Registrar or appropriate school official must complete the appropriate parts of this section and return both pages of the form directly to the Office of the Professions at the mailing address on the form.
If your associate or baccalaureate degree program was in surveying, surveying engineering, surveying engineering technology, or a similar surveying-related title and was accredited by ABET at the time of your graduation or within one year thereafter for land surveying, the Registrar must complete Parts B and C.
(NOTE: For applicants applying to take Part 1 of the licensing examination based on education only, such a program must be at the baccalaureate level and they must have either graduated from or be within 20 semester hours of graduating from the program.)
If your educational program does not fit the criteria in the preceding paragraph, the Registrar must complete Parts A and C. Remind the school that they must attach an official transcript or marksheet of your studies.
When studies were completed at more than one school, official records need to be sent to the Department from each school. Please photocopy the form as needed.
- Form 3 - Verification of Out-of-State Licensure, Registration and/or Examination ( 19 KB)
- Use this form only if you are or have been licensed
as a land surveyor in another jurisdiction or if you want
to verify that you passed the Fundamentals of Land Surveying
Examination and/or the Principles and Practice of Land
Surveying examination in another jurisdiction.
If applying for 7208(b) Interim practice, verification of licensure from your current jurisdiction of residence is required.
This form must be submitted directly by the licensing authority. The Office of the Professions will not accept this form if submitted by the applicant.
- Section I: Complete this section before sending the entire form to each appropriate licensing authority. Be sure to sign and date item 8.
- Section II: The licensing authority must complete this section, sign, date and return all pages of the form directly to the Office of the Professions at the address at the end of the form.
Please photocopy this form as needed.
- Form 4 - Report of Professional Experience ( 13 KB)
- Complete and send both pages of this form directly to the
Office of the Professions at the address at the end of the
form. List all experience that you wish to be evaluated for
licensure. Your experience must be listed in chronological
order beginning with your first employment for which experience
is being claimed, and include firm name, name of endorser,
beginning and ending dates, and total time claimed for each
endorser. Be sure to sign and date item 6.
You must also complete a separate Form 4A for every employer you list on this form. Your application will not be reviewed by the Board until a Form 4A for every employer listed has been received.
When an endorsement does not lend credibility to your experience, it may be discounted at the judgement of the Board. A Form 4A that is not endorsed will not receive any credit towards licensure.
- Form 4A - Verification of Professional Experience ( 22 KB)
- This form must be submitted directly by the endorser.
The Office of the Professions will not accept this form
if submitted by the applicant.
- Sections I and II: Complete these sections, in parts A and B of Section II, list your experience in a comprehensive, detailed, and explicit manner. Be sure to sign and date the attestation at the end of Section II before giving the entire form to the licensed land surveyor who will verify your experience. Descriptions must be specific about your personal contributions to land surveying projects to which you were assigned. Avoid terms like "...participated in...," "...involved with...," or similar generalities. State your exact duties. Your personal surveying work must be described in reasonable detail. Regardless of the total time claimed on a single sheet, you must break the total time down in segments, each of which describes one kind of work you have performed. For each segment, provide a detailed description of your personal activities that would allow the State Board to properly evaluate that work. Remember to indicate in the time column the total time you spent on each specific kind of work. Attach additional sheets if necessary.
- Section III: The licensed land surveyor who will verify your experience must complete this section, sign the attestation endorsing your professional experience before returning all pages of this form directly to the Office of the Professions at the address at the end of the form. The endorser's signature on Form 4A must be notarized by a Notary Public.
A separate Form 4A must be submitted for each instance of professional experience you list on the Report of Professional Experience form (Form 4). Your application will not be reviewed by the Board until a Form 4A for every employer listed has been received.
- Form 5 - Notification of Intent to Practice Land Surveying under Section 7208(b) of Education Law (for Endorsement Candidates only) ( 12 KB)
- Use this form only if you wish to engage in interim
practice while your application for licensure is being
reviewed and you:
- are not a resident of New York State;
- have no established place of practice in this State, or
- are a resident of this State, but have arrived only within the past six months
You must have filed an application for licensure as a land surveyor in New York and must be legally qualified to practice in the jurisdiction in which you currently reside or have a place of practice, or in your previous residence or place of practice (a Verification of Out-Of-State Licensure, Registration and/or Examination form must be submitted to verify this license/current registration). Interim practice will only be approved for a limited time to allow the Department time to review your application for licensure. If you are approved to practice for an interim period, you will not be allowed to claim or in any way state that you are providing services as a land surveyor licensed in New York State.