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#1681, Application for Licensure by Endorsement

Wisconsin Department of Safety and Professional Services Mail To: Box 8935 Office Location: 4822 Madison Yards Way Madison, WI 53708-8935 Madison, WI 53705 FAX #: (608) 251-3036 E- Mail: #: (608) 266-2112 Website: EXAMINING BOARD INSTRUCTIONS FOR OBTAINING Licensure BY Endorsement AN Application IS NOT COMPLETE UNTIL ALL OF THE FOLLOWING DOCUMENTS HAVE BEEN RECEIVED: for Licensure by Endorsement (Form #1681)2.$ Initial Credentialing Fee - Must accompany the completed Application . Please make check or money order payable to Departmentof Safety and Professional Services (DSPS). You may submit payment by completing Form 3071, training course on statutes and rules that apply to practice. Once the one-hour course is complete a Certificate ofCompletion must be submitted directly from the school.

COSMETOLOGY EXAMINING BOARD INSTRUCTIONS FOR OBTAINING LICENSURE BY ENDORSEMENT ... issuance, if license was obtained through examination or reciprocity, and a statement regarding disciplinary actions. Page 2 of 3 Committed to Equal Opportunity in Employment and Licensing.

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