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Board of Licensed Professional Counselors and Therapists
INTERN REGISTRATION FORMS
Please note: some forms may have our old Suite #160 still on them. Please use Suite #250 when having transcripts and exam scores sent to the Board office.
 
* Form #1 - Applicant Information / Request for Licensure
 
* Form #2 - Post Degree Supervised Work Experience
 
* Form #2A - Degree Program Work Experience
 
* Form #3 - Examination Verification
 
* Form #5 - Professional Disclosure Statement Sample
 
* Form #6A - Degree Program Documentation
      Degree Letter to Applicant      Degree Letter to School
 
* Form #7 - Plan for Supervised Work Experience
 
 
 
 
Page updated: February 23, 2008

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