North Carolina Administrative Code › Title 21 - OCCUPATIONAL LICENSING BOARDS AND COMMISSIONS › Chapter 63 - SOCIAL WORK CERTIFICATION › Section .0200 - CERTIFICATION › Section 63 .0213 - TEMPORARY LICENSES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Pursuant to
				G.S.
				90B-8(b), any nonresident
				clinical social worker certified, registered, or licensed in another
				jurisdiction desiring to obtain a temporary license from the Board shall make
				application to the Board. Applications not completed within two years of
				submission to the Board shall be denied. Application forms and instructions may
				be found on the Board's website at
https://www.ncswboard.org
.A temporary
				license shall expire six months following the date of issuance and is not
				eligible for renewal. No individual shall hold more than one temporary license
				within a five-year period.
(b) An
				applicant pursuant to this Rule shall provide the following information on the
				application set forth in Paragraph (a) of this Rule:
(1) the applicant's name, contact
				information, signature, and date of signature;
(2) the social security number of the
				applicant;
(3) the requested
				designation of licensure type;
(4)
				the applicant's place of employment, the name of the applicant's supervisor,
				and the license number of the applicant's supervisor, if the supervisor holds a
				license to practice clinical social work;
(5) educational history and degree
				attainment;
(6) whether the
				applicant has ever been certified, licensed, or registered to practice social
				work by the Board, by another occupational board or agency, or in another
				state/jurisdiction and, if so:
(A) what
				credential was held;
(B) in what
				state/jurisdiction;
(C) the
				issuance date and expiration date; and
(D) what examinations were taken to obtain
				said certification, licensure, or registration;
(7) whether the applicant ever has had a
				credential denied, limited, reprimanded, suspended, or revoked;
(8) whether the applicant ever has been
				convicted of a felony or misdemeanor under any laws;
(9) whether any criminal charges are pending
				against the applicant;
(10) whether
				any court, board, agency, or professional organization has found the applicant
				guilty of misconduct, unprofessional conduct, dishonest or fraudulent practice,
				or incompetent practice;
(11)
				whether any charges are pending against the applicant before any court, board,
				agency, or professional organization for unprofessional conduct, dishonest or
				fraudulent practice, or incompetent practice;
(12) the applicant's certification that:
(A) the applicant has read the North Carolina
				General Statute 90B Social Worker Certification and Licensure Act, and the
				Board's rules, ethical guidelines, and disciplinary procedures, which are
				available on the Board's website at
https://www.ncswboard.org
,and agrees to
				comply with them;
(B) the
				information provided by the applicant in the application is true;
(C) the applicant consents to a criminal
				history record check;
(D) the
				applicant's consent for the jurisdiction in which the applicant is licensed to
				release information to the Board related to the applicant's licensure status
				and practice of social work;
(E)
				the applicant has read and understands the public notice statement on employee
				misclassification that is set forth in the application and has disclosed any
				investigations for employee misclassification, and its results, over the
				preceding 12-month period, as prescribed by
				G.S.
				143-789; and
(13) an application fee of twenty-five
				($25.00) dollars.