LCSW / LISW Initial Application - Personal Information - NVSWE

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LCSW / LISW Initial Application - Personal Information

While you are in the online application process please do not use the back button in your browser. If at any time you need to make a correction to a prior page or exit the application process, please either click the "Save for Later" or "Exit" button located at the bottom of the page.

License Information

I am applying for

Application Type

Personal Information

Please provide your present legal name.

Do you have any other name(s) ever used?
Contact Information

Primary Email: The Board will use this email address to communicate with you. This email address will be added to the Board Listserv, which is used to communicate information pertinent to all licensees.