Request a record transfer through the Social Work Registry

Complete this form to request a record transfer.

"*" indicates required fields

Name*

First Last

Your date of birth*

Email*

Jurisdiction in which licensure is desired*

Documents that you are requesting the Registry to send on your behalf:

Score report: Associate

Score report: Bachelors

Score report: Masters

Score report: Advanced Generalist

Score report: Clinical

Have you submitted your application to the desired jurisdiction?*

Yes

License verification(s)

Please type the state(s) or province(s).

Transcript

Please type school name(s)

Supervision (if applicable)

Please list supervisor's name.

Other

Please indicate