Form 08-4398 - Application For Landscape Architect Registration By Examination Or Comity Page 3
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5PERSONAL AND PROFESSIONAL REFERENCE LIST (AS 08.48.201(a)(3))
Name
Address
Daytime Telephone
Occupation
Registration No.
1.
2.
3.
4.
5.
EXAMINATION AND REGISTRATION
EXAMS PASSED:
L.A.R.E. Section
State
Year
Other Exams
State
Year
PROFESSIONAL REGISTRATIONS:
List all states where you hold or have held registration. Use a separate sheet if
necessary. Verification of current registration is needed from at least one state as well as verification from the state(s) where
examination(s) was/were administered. A form is provided in this application packet. Copy as necessary and send to the
appropriate states for completion. If you are submitting a CLARB certificate, a separate verification from the state(s) is not
needed.
License
Year
Hours Written
Comity or
Active or
Type of License
Number
State
Registered
Examination
Exam
Lapsed
TECHNICAL EDUCATION: (Official Transcripts must be submitted directly from the school, unless verified in your CLARB
record.)
Years Attended
Date of
Degree
Name and Address of Institution
Graduation
Received
From
To
08-4398 (Rev. 12/00)
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