Temp. License Compliance Verification Form
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Temp. License Info Compliance Form Change Form Applications

Temporary License Compliance Verification Form:

The Temporary License Compliance Verification Form (due in July of each year from temporary licensees) has been combined so that one form may be used by both the TL and TD license holders. This form must be faxed or mailed to the Board of Social Work Examiners during the month of July or as soon thereafter as possible.

 

Downloadable / Printable Version of Temporary License Compliance Verification Form:

Get Adobe ReaderTemporary License Compliance Verification Form - Adobe Reader (PDF) Format - 1 page - 142 KB

 

Completed Temporary License Compliance Verification Forms must be mailed or faxed to the Board office:

WV Board of Social Work Examiners
PO Box 5459
Charleston, WV 25361

Fax: (304) 558-4189