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Associate Clinical Social Worker application packet

STATE OF CALIFORNIA - BUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY Governor Edmund G. Brown Jr. Board of Behavioral Sciences 1625 North Market Blvd., Suite S200, Sacramento, CA 95834. Telephone: (916) 574-7830 TTY: (800) 326-2297. Associate Clinical Social Worker . REGISTRATION. application packet . Dear Applicant: Thank you for your interest in becoming registered in California as an Associate Clinical Social Worker . Included in this packet are: 1. application Instructions 2. Important Information for ASW Applicants 3. application for Registration as an ASW. 4. Important Live Scan Information and Instructions 5. Request for Live Scan Service Form BOARD OF BEHAVIORAL SCIENCES. STATE OF CALIFORNIA - BUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY Governor Edmund G. Brown Jr. Board of Behavioral Sciences 1625 North Market Blvd., Suite S200, Sacramento, CA 95834. Telephone: (916) 574-7830 TTY: (800) 326-2297. application INSTRUCTIONS. Associate Clinical Social Worker REGISTRATION.

•Complete all sections of the application in ink. •The application must have your original signature. •You must use your legal name. Your “legal name” is the name established

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