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All applicants for licensure must complete this form and submit it with the appropriate fee for licensure and first registration directly to the Office of the Professions at the address at the end of Form 1. Make checks payable to the New York State Education Department. NOTE: Your cancelled check is your receipt.

You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review. Your signature on Form 1 must be notarized by a Notary Public.

Change Address or Name  - You are required to notify us within 30 days of any address or name changes. Please read the instructions to request this change.