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The North Carolina Board of Licensed Professional Counselors (NCBLPC) LPC Associate Licensure Application is a crucial step for new graduates aspiring to become licensed professional counselors. This application serves as a comprehensive checklist, ensuring that applicants meet all necessary requirements before obtaining their LPC license. Key components include personal information, educational background, and professional references. Applicants must provide their Social Security number and date of birth, list all relevant licenses and certificates, and submit official transcripts from graduate institutions. Legal and ethical history is also examined, requiring detailed explanations for any affirmative responses to specific questions. Additionally, applicants must document their graduate counseling experience, including practicums and internships, and ensure that a faculty member verifies this experience. The application process also involves submitting fingerprint cards for background checks, a professional disclosure statement, and a jurisprudence exam certificate. Completing the application accurately and thoroughly is essential for a smooth licensure process.
Nc Blpc Example
Checklist for LPCA Applicants
I have read the Application Process for LPCAs.
I have completed all of Section I. Social Security Number and Date of Birth are
required.
I have listed all licenses and certificates that I hold issued in North Carolina and
other states in Section II.
I have enclosed a written explanation for questions answered with a “Yes” in
Section III — Legal and Ethics History.
I have listed all graduate institutions attended in Section IV and have requested
transcripts to be sent directly to the NCBLPC.
I have listed three (3) professional references with contact information and the
length of time I have known them in Section V.
I have listed my graduate counseling experience (practicum and internship) in
Section VI and I have requested that a faculty member in my university counseling
department complete the Verification of Graduate Counseling Experience form to be
sent directly to the NCBLPC.
I have listed my graduate course work with course codes and semester or quarter hours
in Section VII.
I have attached a photo (no larger than 2“ x 2”), signed and dated the application
and have had my application notarized in Section VIII.
I have signed and dated the application in the presence of a Notary Public and have had
my application notarized in Section IX.
I have enclosed two fingerprint cards and the Authority for Release of Information (see
page 11) to be submitted by the NCBLPC for state and national background checks to
be performed by the SBI and FBI as required in Section XII.
I have included my application fee of $238, includes fee for criminal background check
I have included my LPCA Professional Disclosure Statement.
I have included my LPCA Jurisprudence Exam Certificate of Completion.
North Carolina Board of Licensed Professional Counselors
LPC Associate Licensure Application
Pre-requisite for LPC license for new graduates
Revised 03/25/14 This version supersedes all previous versions Application Page 1 of 10
North Carolina Board of Licensed Professional Counselors
Licensure Application
Licensed Professional Counselor Associate
Pre-requisite for LPC license for new graduates
APPLICATION INSTRUCTIONS
1. PRINT or TYPE using BLACK Ink to complete this application.
2. Applicants must complete ALL SECTIONS. Read carefully.
3. A completed application and other required support documentation are to be mailed in one packet to the Board’s address.
4. The application fee is $200 plus an additional $38 for the criminal background check and must accompany the application when
mailed. Application fees are non-
refundable.
I. GENERAL INFORMATION - To be completed by all applicants.
Name (Last, First, Middle): Social Security Number: Date of Birth:
___________________________________________ ______________________ ______________________
(required) (mm/dd/yyyy)
Please include maiden name and/or any other alias:
________________________________________________
Mailing Address (Street and/or Box Number, City, State, Zip Code): Home Phone:
__________________________________________________________ _________________________
Email Address: Mobile Phone:
___________________________________________________________ _________________________
Business Name & Address (is this an exempt setting, such as a school, university or government agency)?: Yes No
_________________________________________________ Work Phone:
_________________________________________________ _________________________
_________________________________________________
Email Address: Work Fax:
_________________________________________________ _________________________
II. CREDENTIALS
- To be completed by all applicants, if applicable.
List all professional credentials which you now hold or have ever held in order of attainment.
License/Certificate Type License/Certificate # Issued Date Issued By
Revised 03/25/14 This version supersedes all previous versions Application Page 2 of 10
For Office Use Only Date Rec’d: Payment: CC Check MO Amount $
Name of Applicant: (Required)
III. LEGAL & ETHICS HISTORY
- To be completed by all applicants. All applicants are REQUIRED to submit two
(2) fingerprint cards, the Authorization for Release of Information and payment of $38 to the NCBLPC for a state and
national background check to be performed.
1. Have you ever been denied the privilege of taking an occupational licensure or certification examination? If
yes, state what type of occupational examination, where, and provide final written decision from the
denying Board on a separate sheet of paper.
2. Have you ever had any disciplinary action taken against an occupational license or certificate to practice or
are any such actions pending? If yes, explain in detail on a separate sheet of paper.
3. Have you ever been convicted of a violation of/or pled nolo contend ere to any federal, state, or local
statute, regulation or ordinance or entered into any plea bargain for violations, except for minor traffic
violations? If yes, see below.**
4. Within the past four years, have you been unable to engage in the practice of counseling due to a physical
and/or emotional dependency or use of alcohol and/or drugs? If yes, please provide a letter from your
treating professional summarizing diagnosis, treatment and prognosis.
5. Within the past four years, have you been unable to engage in the practice of counseling due to treatment
and/or hospitalization for a nervous, emotional or mental disorder? If yes, please provide a letter from your
treating professional summarizing diagnosis, treatment and prognosis.
6. Have you ever been censured, warned, or requested to withdraw from your practice/employment,
terminated from any health care facility, agency, or practice for reasons involving your conduct as a
counselor? If yes, please provide an explanation on a separate sheet of paper.
7. Have you ever been convicted of an offense involving the taking of illegal drugs or the consumption of
alcohol? If yes, see below.**
If you answered YES to questions 3 and/or 7, you must submit:
1) A written explanation of the event(s).
2) A written explanation on how you have dealt with the circumstances that lead up to the event(s).
IV. EDUCATION
- To be completed by all applicants. Official Graduate Transcripts from each of the Universities listed
below must be submitted directly to the NCBLPC Board Office from the Graduate Institution.
Graduate Institution Dates of Attendance Major/Degree Received Date Degree
(Undergraduate Not Required) From To Conferred
V. REFERENCES
- To be completed by all applicants. Please list three individuals (may include supervisors) who are
acquainted with your professional counseling work.
Name, Address, & Phone Title Yrs Known
This version supersedes all previous versions
Application Page 3 of 10
1.
Yes No
2.
Yes No
3.
Yes No
4.
Yes No
5.
Yes No
6.
Yes No
7.
Yes No
Revised 03/25/14
Name of Applicant: (Required)
VI. Graduate Counseling Experience - To be completed by all applicants. List below your graduate Practicum and
Internship experiences (use additional sheets if necessary). These experiences should appear on your graduate transcript(s).
Send Verification of Graduate Counseling Experience form(s) to your University. A faculty member/university supervisor
should complete the form and send it directly to the NCBLPC. Practicum and Internship are defined in Rule .0701(B).
1. Dates of Practicum Total # of weeks: # of hours per week:
From: To: Course # and Title:
Graduate Institution: University Supervisor:
Practicum/Internship Site: Site Supervisor:
Position Held/Responsibilities:
2. Dates of Practicum Total # of weeks: # of hours per week:
From: To: Course # and Title:
Graduate Institution: University Supervisor:
Practicum/Internship Site: Site Supervisor:
Position Held/Responsibilities:
3. Dates of Internship Total # of weeks: # of hours per week:
From: To: Course # and Title:
Graduate Institution: University Supervisor:
Practicum/Internship Site: Site Supervisor:
Position Held/Responsibilities:
4. Dates of Internship Total # of weeks: # of hours per week:
From: To: Course # and Title:
Graduate Institution: University Supervisor:
Practicum/Internship Site: Site Supervisor:
Position Held/Responsibilities:
This version supersedes all previous versions
Application Page 4 of 10
Revised 03/25/14
Name of Applicant: (Required)
VII GRADUATE COURSES
- To be completed by all applicants. Course areas are fully defined in Rule .0701 of the
Administrative Code and are posted on the Board website. In cases where the course title does not clearly reflect course
content, applicants shall provide university course descriptions and/or syllabi for clarification. Each course area must have at
least one 3-semester hour (or 5 quarter hour) course unless otherwise specified.
A. HELPING RELATIONSHIPS IN COUNSELING - shall provide a general knowledge of theories, their principles, and
techniques for application in counseling relationships; shall include crisis intervention and suicide prevention models.
Course Code Date Completed Title Sem/Qtr hrs
B. PROFESSIONAL ORIENTATION TO COUNSELING - shall provide an understanding of all aspects of functioning as a
professional counselor, including a history of the counseling profession, various roles contemporary counselors have in our
society, membership in professional counseling associations, self-care strategies appropriate to the counselor role, ethical
conduct, standards of preparation, credentialing processes, and counseling supervision models, practices, and processes.
Course Code Date Completed Title Sem/Qtr Hrs
C-1. PRACTICUM IN COUNSELING - Applicant’s must have both a Practicum and an Internship as defined in Rule .0206.
Coursework shall be provided in a university-approved counseling setting for at minimum one (1) semester duration (three
semester hours or 5 quarter hours of credit) for Practicum and one (1) semester duration for Internship of academic credit
in a regionally accredited program of study.
Course Code Date Completed Title Sem/Qtr Hrs
C-2. INTERNSHIP IN COUNSELING - Applicant’s must have both a Practicum and an Internship as defined in Rule .0206.
Coursework shall be provided in a university-approved counseling setting for at minimum one (1) semester duration (three
semester hours or 5 quarter hours of credit)for Practicum and one (1) semester duration for Internship of academic credit
in a regionally accredited program of study.
Course Code Date Completed Title Sem/Qtr Hrs
Revised 03/25/14
This version supersedes all previous versions
Application Page 5 of 10
Name of Applicant: (Required)
VII. GRADUATE COURSES (continued)
- To be completed by all applicants. Course areas are fully defined in
Rule .0701 of the Administrative Code and are posted on the Board website. In cases where the course title does not clearly
reflect course content, applicants shall provide university course descriptions and/or syllabi for clarification. Each course area
must have at least one 3-semester hour (or 5 quarter hour) course unless otherwise specified.
D. ASSESSMENT IN COUNSELING - shall include studies that provide a broad understanding of historical perspectives
concerning the nature and meaning of assessment as well as basic concepts of standardized and non-standardized testing
and other assessment techniques.
Course Code Date Completed Title Sem/Qtr Hrs
E. CAREER COUNSELING AND LIFESTYLE DEVELOPMENT - shall include studies that provide a broad understanding of
career development theories and decision-making models as well as career and educational planning, placement, follow-
up, and evaluation.
Course Code Date Completed Title Sem/Qtr Hrs
F. GROUP COUNSELING THEORIES AND PROCESSES - shall include studies that provide a broad understanding of
group development, dynamics, methods, and counseling theories; shall help students understand group leadership styles,
basic and advanced group skills, and other aspects of group counseling and group consultation.
Course Code Date Completed Title Sem/Qtr Hrs
G. HUMAN GROWTH AND DEVELOPMENT THEORIES IN COUNSELING - shall provide a broad understanding of human
behavior, including an understanding of developmental crises, disability, psychopathology, and situational and
environmental factors that affect both normal and abnormal behavior.
Course Code Date Completed Title Sem/Qtr Hrs
Revised 03/25/14 This version supersedes all previous versions Application Page 6 of 10
Name of Applicant: (Required)
VII. GRADUATE COURSES (continued)
- To be completed by all applicants. Course areas are fully defined in
Rule .0701 of the Administrative Code and are posted on the Board website. In cases where the course title does not clearly
reflect course content, applicants shall provide university course descriptions and/or syllabi for clarification. Each course area
must have at least one 3-semester hour (or 5 quarter hour) course unless otherwise specified.
H. RESEARCH AND PROGRAM EVALUATION - shall include studies that provide a broad understanding of the importance
of research in advancing the counseling profession; study of research methodology, statistical methods, the use of
research to inform evidence-based practice; and ethical and culturally relevant strategies for interpreting and reporting the
results of research and/or program evaluation studies.
Course Code Date Completed Title Sem/Qtr Hrs
I. SOCIAL AND CULTURAL FOUNDATIONS IN COUNSELING - shall provide an understanding of theories of multicultural
counseling, identity development, and social justice while examining multicultural and pluralistic trends, including
characteristics and concerns within and among diverse groups nationally and internationally.
Course Code Date Completed Title Sem/Qtr Hrs
Revised 03/25/14
This version supersedes all previous versions
Application Page 7 of 10
Name of Applicant: (Required)
VIII. PHOTO
IX. APPLICATION VALIDATON
- To be completed by all applicants. The following statement must be signed in the
presence of a Notary Public. This application is not valid unless properly signed and notarized. Note: Any false or
misleading information in, or in connection with, any application may be cause for denial of application.
The undersigned, being sworn (or affirmed), deposes and says that he/she is the person who executed this application;
that the statements herein contained are true in every aspect; that he/she will conform to the ethical standards and
standards of practice in his/her professional conduct; that he/she has read and understands this affidavit.
The undersigned also understands that the Board has the authority to conduct a full criminal record search, including
state and national records.
Applicant’s Full Name (PRINTED):
Applicant’s Signature:
Notary Information: State of
City/County of
Sworn to (or affirmed) and subscribed before me,
on this, the
day of , 20
SEAL
Notary Public:
My Commission Expires:
The NCBLPC is charged with the responsibility of reviewing and acting on the applications of qualified persons who are
adequately prepared in professional counseling. The Board has no jurisdiction over professions or professionals prepared in
other fields that are licensed/certified by other Boards such as Marriage & Family Therapy, Psychology, Fee-Based Pastoral
Counseling, Substance Abuse and Social Work.
Mail completed application to: NCBLPC ♦ PO Box 1369 ♦ Garner, NC 27529
Revised 03/25/14
This version supersedes all previous versions
Application Page 8 of 10
Please attach a passport size photo
with tape on each side
Photo should be no larger than 2” x 2”
Revised 03/25/14
This version supersedes all previous versions
Application Page 9 of 10
Instructions for Completing the Applicant Fingerprint Card
Please go to your local law enforcement agency (police department or sheriff’s office) and request that they make two
fingerprint cards. The bearer of this letter is seeking to obtain a copy of his or her criminal history record information for
pursuant to NCGS 90-345(b) in order to obtain a license from the North Carolina Board of Licensed Professional
Counselors.
1. The complete name of the subject is to be listed as indicated: last name, first name, and middle name. Please
ensure the name is legible if written.
2. List any and all alias names or nicknames, maiden name, or any other married names.
3. Sex is to be listed as M for Male and F for Female or U for Unknown.
4. Race is to be listed by placing an individual into one (1) of the following categories by writing the appropriate letter in
the space provided.
W – White
B – Black
I – American Indian or Alaskan Native
A – Asian or Pacific Islander
U – Unknown if unsure or unable to determine
5. Indicate the subject’s height in feet and inches using all numeric.
Example: 6’01’ = 601, 6’11” = 611, 6’ = 600
6. Indicate the subject’s weight in pounds using all numeric.
Example: 186 or 098, etc.
7. List the subject’s eye color by placing one (1) of the following eye color codes in the space provided:
BLK—Black GRY—Gray MAR—Maroon
BLU—Blue GRN—Green PNK—Pink
BRO—Brown HAZ—Hazel XXX—Unknown
8. Color of hair should be indicated by writing one (1) of the following color codes in the space provided:
BAL – Bald (when subject has lost most of his hair or is hairless)
BLK – Black
BLN – Blond or Strawberry
BRO – Brown
GRY – Gray or partially
RED – Red or Auburn
SDY – Sandy
9. List the date of birth numerically– month, day and year
Example: May 11, 1948 should be shown as 05111948
10. Indicate, if possible, the city and state where the subject was born. The state should be indicated by the two letter
abbreviation.
11. OCA block: NCBLPC000
12. Social Security: write in the Social Security Number
13. Residence of Person Fingerprinted: Current residence of subject fingerprinted is written here.
14. Employer Board Address: NC Board of Licensed Professional Counselors, PO Box 1369, Garner NC 27529
15. Reason Fingerprinted: Licensed Professional Counselor per NCGS 90-345, state and federal.
X. Criminal Background Information
Revised 03/25/14
This version supersedes all previous versions
Application Page 10 of 10
AUTHORITY FOR RELEASE OF INFORMATION
State and Federal Record Check
I authorize the North Carolina Department of Justice through the State Bureau of Investigation, Special
Operations Division, to perform a fingerprint search of the State’s criminal history record file and a fingerprint
search of the Federal Bureau of Investigation’s files for a national criminial history record check in connection
with my application for licensure with the North Carolina Board of Licensed Professional Counselors pursuant
to NCGS 90-345.
Please type or print clearly; use only black or blue ink.
________________________ _________________________ ___________________________
Last Name First Name Middle Name
________________________
Maiden Name
________________________ _________________________ _________ _______________
Social Security Number Date of Birth Gender Race
(Optional*)
I understand that the North Carolina State Bureau of Investigation, Special Operations Division, and its
officials and employees shall not be held legally accountable in any way for providing this information to the
North Carolina Board of Licensed Professional Counselors, and I hereby release said agency and persons
from any and all liability which may be incurred as a result of furnishing such information. I further understand
that the North Carolina Board of Licensed Professional Counselors cannot provide the results of this criminal
history record check to me.
* Disclosure of a social security number is entirely voluntary and not required. If disclosed, the social security
number will be utilized to assist with accurate identification/exlusion of possible criminal history checks.
________________________________________________ ____________________________
Signature of Applicant Date
The Authority for Release of Information, the fingerprint card(s) and the fee must be mailed to:
NCBLPC
PO BOX 1369
Garner NC 27529
ORI # NCBC10000 – North Carolina Board of Licensed Professional Counselors
This request form must be maintained on file with the above named agency for one year.
Do not mail this form or a copy of this form
to the State Bureau of Investigation.
XI. Authority for Release for Criminal Background Check
File Breakdown
| Fact Name | Details |
|---|---|
| Governing Body | The North Carolina Board of Licensed Professional Counselors (NCBLPC) oversees the LPC Associate Licensure Application process. |
| Application Fee | The total application fee is $238, which includes the cost of the criminal background check. |
| Required Sections | All applicants must complete every section of the application to be considered for licensure. |
| Social Security Number | Providing a Social Security Number and Date of Birth is mandatory for all applicants. |
| Legal and Ethics History | Applicants must provide written explanations for any "Yes" answers in the Legal and Ethics History section. |
| Graduate Transcripts | Official transcripts from all graduate institutions must be sent directly to the NCBLPC by the institutions. |
| Professional References | Applicants need to list three professional references, including their contact information and duration of acquaintance. |
| Fingerprint Cards | Two fingerprint cards must be included for state and national background checks. |
| Notarization Requirement | Applications must be signed and notarized, confirming the applicant's identity and authenticity of the information provided. |
| Superseded Versions | This application version supersedes all previous versions, ensuring that applicants use the most current form. |
Guide to Using Nc Blpc
Completing the North Carolina Board of Licensed Professional Counselors (NCBLPC) LPC Associate Licensure Application requires attention to detail and adherence to specific guidelines. The application consists of several sections that must be filled out accurately. Each section addresses different aspects of your qualifications and background. Following the steps outlined below will help ensure that your application is complete and ready for submission.
- Print or type the application using black ink.
- Complete all sections of the application. Review the instructions carefully.
- Gather and include all required supporting documentation in one packet.
- Prepare the application fee of $238, which includes the fee for the criminal background check.
- In Section I, provide your general information, including your name, Social Security Number, and date of birth.
- In Section II, list any licenses or certificates you hold, including details such as license type and issuing authority.
- For Section III, answer all questions regarding your legal and ethics history. Include explanations for any "Yes" answers.
- In Section IV, list all graduate institutions you attended and ensure transcripts are sent directly to the NCBLPC.
- Provide details for three professional references in Section V, including their contact information and how long you have known them.
- Document your graduate counseling experience in Section VI, and arrange for verification from a faculty member.
- In Section VII, list your graduate coursework, including course codes and hours completed.
- Attach a photo (2” x 2”), and ensure the application is signed, dated, and notarized as required in Sections VIII and IX.
- Include two fingerprint cards and the Authority for Release of Information as specified in Section XII.
- Finally, review the application for completeness and accuracy before mailing it to the Board's address.
Get Answers on Nc Blpc
-
What is the NC BLPC form?
The NC BLPC form is the application for Licensed Professional Counselor Associate (LPCA) licensure in North Carolina. It is a crucial step for new graduates seeking to obtain their LPC license. The form outlines the necessary qualifications and documentation required for licensure.
-
Who needs to fill out the NC BLPC form?
New graduates who wish to become Licensed Professional Counselor Associates in North Carolina must complete this form. It is specifically designed for those who have completed their graduate counseling education and are seeking licensure.
-
What are the main sections of the NC BLPC form?
The form consists of several sections, including:
- General Information
- Credentials
- Legal and Ethics History
- Education
- References
- Graduate Counseling Experience
- Graduate Courses
Each section must be completed accurately to ensure a smooth application process.
-
What documentation is required with the application?
Applicants must submit various documents, including:
- Official transcripts from graduate institutions
- Professional references
- Verification of Graduate Counseling Experience form
- Two fingerprint cards for background checks
- Application fee of $238
- LPCA Professional Disclosure Statement
- LPCA Jurisprudence Exam Certificate of Completion
All documents should be mailed together in one packet to the Board’s address.
-
How much is the application fee?
The total application fee is $238. This includes a $200 processing fee and an additional $38 for the criminal background check. It is important to note that application fees are non-refundable.
-
What if I have a legal or ethics history?
If you answer "Yes" to any questions regarding your legal or ethics history in Section III, you must provide a written explanation. This includes details about any disciplinary actions, convictions, or other relevant events. Supporting documentation may also be required.
-
What is the significance of the Graduate Counseling Experience section?
This section is critical as it outlines your practical experience in counseling. You must list your practicum and internship experiences, including details about your responsibilities and the supervising faculty member. Verification forms must be sent directly from your university to the NCBLPC.
-
How should I complete the form?
Applicants should print or type their responses using black ink. It is essential to complete all sections carefully and to ensure that all required documents are included before mailing the application. Incomplete applications may delay the licensure process.
-
What happens after I submit my application?
Once your application is submitted, the North Carolina Board of Licensed Professional Counselors will review it. They may contact you for additional information or clarification. If approved, you will be notified of the next steps to obtain your LPCA license.
Common mistakes
Filling out the NC BLPC form can be a straightforward process, but many applicants make common mistakes that can delay their application. One frequent error is not providing a complete Social Security Number and Date of Birth. Both of these details are required and must be filled out accurately. Omitting this information can lead to immediate rejection of the application.
Another mistake is failing to list all licenses and certificates held in North Carolina and other states. In Section II, applicants must include every relevant credential. Missing even one can raise questions about the applicant's qualifications and may result in delays.
Some applicants overlook the need for a written explanation for any "Yes" answers in Section III regarding legal and ethics history. This explanation is crucial. It provides context and helps the board understand the applicant's situation. Without it, the application may be considered incomplete.
Additionally, many forget to request their graduate transcripts to be sent directly to the NCBLPC. This step is essential and must be completed in Section IV. If transcripts are not sent directly from the institution, the application process can be significantly delayed.
Providing insufficient references is another common issue. In Section V, applicants must list three professional references along with their contact information. Not including enough references or failing to provide accurate contact details can hinder the application process.
In Section VI, applicants must document their graduate counseling experience. Some people fail to request that a faculty member complete the Verification of Graduate Counseling Experience form. This is a vital part of the application, and without it, the application may not be processed.
Lastly, many applicants forget to include their application fee. The total fee of $238 must accompany the application. Failing to include this payment will result in the application being returned. Remember, application fees are non-refundable, so it's important to double-check this before submission.
Documents used along the form
When applying for licensure as a Licensed Professional Counselor Associate (LPCA) in North Carolina, several key documents accompany the NC BLPC form. Each of these documents serves a distinct purpose in ensuring that applicants meet the necessary requirements for licensure. Below is a list of commonly required forms and documents that are essential to the application process.
- Verification of Graduate Counseling Experience Form: This document is completed by a faculty member from the applicant's university. It confirms the applicant's practicum and internship experiences, detailing the responsibilities and hours worked in a counseling setting.
- Professional Disclosure Statement: This statement outlines the counselor's qualifications, services offered, and ethical obligations. It is crucial for informing clients about the counselor's professional background and practice.
- Jurisprudence Exam Certificate of Completion: Applicants must pass this exam to demonstrate their understanding of the laws and ethical standards governing the practice of counseling in North Carolina.
- Fingerprint Cards: Two fingerprint cards are required for background checks. These cards allow the North Carolina State Bureau of Investigation (SBI) and the Federal Bureau of Investigation (FBI) to conduct thorough criminal background checks.
- Authority for Release of Information: This document authorizes the NCBLPC to obtain necessary background information from relevant agencies, ensuring that the applicant's history is accurately reviewed.
- Application Fee Payment: The fee, which totals $238, must be included with the application. This payment covers the processing of the application and the associated background checks.
- Transcripts from Graduate Institutions: Official transcripts must be sent directly from the applicant's graduate schools to the NCBLPC. These transcripts verify the applicant's educational qualifications and completion of required coursework.
- Professional References: Applicants need to provide contact information for three professional references who can vouch for their counseling skills and ethical conduct. These references play a vital role in the evaluation process.
- Photo Identification: A recent photo (no larger than 2” x 2”) is required for identification purposes. This photo is included with the application to help verify the applicant's identity.
Each of these documents plays a critical role in the application process for LPCA licensure. Together, they help ensure that applicants are well-prepared and qualified to enter the counseling profession in North Carolina. It is important to complete each form accurately and submit all required documentation in a timely manner to facilitate a smooth application process.
Similar forms
- Application for Licensure: Similar to the NC BLPC form, this document is also used for individuals seeking professional licensure. It requires personal information, educational background, and professional experience. Both forms necessitate a thorough review of the applicant's qualifications and history.
- Background Check Authorization Form: Like the NC BLPC form, this document is essential for verifying an applicant's criminal history. Both forms require the submission of fingerprint cards and may involve state and national background checks.
- Professional Reference Form: This document is akin to the references section of the NC BLPC form. It gathers information about individuals who can vouch for the applicant's professional experience and character, ensuring that the applicant meets the necessary standards for licensure.
- Verification of Graduate Counseling Experience Form: This form parallels the requirements outlined in the NC BLPC form regarding practicum and internship experiences. It confirms the applicant's hands-on training and is often submitted directly by a faculty member, ensuring that the applicant has met the educational and experiential prerequisites for licensure.
Dos and Don'ts
When filling out the North Carolina Board of Licensed Professional Counselors (NCBLPC) form, consider the following guidelines:
- Ensure all required sections are completed accurately, especially your Social Security Number and Date of Birth.
- Double-check that you have enclosed all necessary documents, such as transcripts and fingerprint cards.
- Provide clear and detailed explanations for any "Yes" answers in the Legal and Ethics History section.
- Sign and date the application in the presence of a Notary Public.
Conversely, avoid these common pitfalls:
- Do not leave any required fields blank; incomplete applications may be rejected.
- Avoid using any ink color other than black when filling out the form.
- Do not forget to include your application fee; it is non-refundable.
- Refrain from submitting documents separately; mail everything in one packet.
Misconceptions
Here are nine common misconceptions about the North Carolina Board of Licensed Professional Counselors (NCBLPC) LPC Associate application form, along with clarifications:
- Misconception 1: The application can be submitted without all required documents.
- Misconception 2: Only a few references are needed.
- Misconception 3: The application fee is refundable.
- Misconception 4: Transcripts can be sent by the applicant.
- Misconception 5: Fingerprint cards are optional.
- Misconception 6: It’s acceptable to leave "Yes" answers in the legal and ethics history section unexplained.
- Misconception 7: A photo is not necessary for the application.
- Misconception 8: There is no need for notarization.
- Misconception 9: You can submit the application without completing the Jurisprudence Exam.
This is incorrect. All sections of the application must be completed, and all required documentation should be submitted together in one packet.
In fact, you must provide three professional references with their contact information and the duration of your acquaintance.
Application fees are non-refundable, so ensure that all information is accurate before submitting.
Transcripts must be sent directly from the graduate institutions to the NCBLPC Board Office.
Two fingerprint cards are required for the state and national background checks, so they must be included with your application.
Any "Yes" answers must be accompanied by a detailed written explanation on a separate sheet.
A photo (no larger than 2” x 2”) must be attached to the application.
The application must be signed and dated in the presence of a Notary Public and notarized.
Including your LPCA Jurisprudence Exam Certificate of Completion is a mandatory part of the application process.
Key takeaways
Filling out the North Carolina Board of Licensed Professional Counselors (NCBLPC) LPC Associate Licensure Application (BLPC form) requires careful attention to detail. Below are key takeaways to consider:
- Complete All Sections: Ensure that every section of the application is filled out completely. Missing information can delay the processing of your application.
- Documentation Requirements: Gather all necessary documents, including transcripts, fingerprint cards, and the Authority for Release of Information. These must be submitted with your application.
- Fees: The total application fee is $238, which includes the fee for the criminal background check. Payment must accompany the application and is non-refundable.
- Legal and Ethics History: Be prepared to provide explanations for any "Yes" answers in the Legal and Ethics History section. Additional documentation may be required.
- Notarization: The application must be signed and dated in the presence of a Notary Public. Ensure that all notarization requirements are met before submission.
Following these guidelines will help streamline the application process and increase the likelihood of a successful submission.