Prof.-Application for Licensure

Attach a clear, full-face passport- What are you applying for? style photograph (2 x 2 ) of your Authorization to sit for the head and shoulders, taken within National counselor Exam the past six months. New Jersey Office of the Attorney General Licensure as an associate A photo is required with each Division of Consumer Affairs counselor State Board of Marriage and Family Therapy Examiners application. Professional counselor Examiners Committee Licensure as a Professional 124 Halsey Street, 6th Floor, Box 45044 counselor Do not use staples to attach the Newark, New Jersey 07101. photo. (973) 504-6582 Licensure as a Rehabilitation counselor Application for Licensure Professional counselor /Rehabilitation counselor / associate counselor Date :_____. A nonrefundable application filing fee of $75, in the form of a check or money order made out to the State of New Jersey, must be submitted with this application.

Application Categories. I hereby apply for the following type of license: (Please check the appropriate boxes.) Licensed Associate Counselor (LAC)

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  Counselor, Associate, Associate counselor

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