Form 08-4403 - Professional Counselor Licensure Application - Juneau - 2013

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STATE OF ALASKA
DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC DEVELOPMENT
DIVISION OF CORPORATION, BUSINESS AND PROFESSIONAL LICENSING
BOARD OF PROFESSIONAL COUNSELORS
P.O. BOX 110806, JUNEAU, ALASKA 99811-0806
(907) 465-2551
E-mail: license@alaska.gov
Website:
PROFESSIONAL COUNSELOR LICENSURE APPLICATION
Please read the instructions before you complete the application.
A person may apply for licensure to practice professional counseling in the State of Alaska under the provisions of
AS 08.29. Applicants may qualify for licensure by credentials (see Part I) or by examination (see Part II).
If you have questions concerning the admission requirements, please contact the licensing examiner at (907) 465-2551.
PART I – LICENSURE BY CREDENTIALS
The board will issue a license to practice professional counseling without examination to an applicant who holds a current
license to practice professional counseling in another jurisdiction that has requirements for licensure substantially the
same or higher than those of this state (AS 08.29.120(a)).
The following documents are needed for licensure by credentials:
1.
A completed and notarized application and $50.00 nonrefundable application fee (form 08-4403).
2.
Initial licensure fee of $275.00. All licenses are renewed biennially October 31 of odd numbered years.
3.
Verification of Licensure from each state where currently licensed or have held a license (form 08-4403a). The
state must verify any disciplinary actions taken or pending.
4.
Each applicant is to submit a complete report of criminal justice information under AS 12.62.005 – AS 12.62.200
for Alaska. The Alaska report can be obtained by contacting the Department of Public Safety, Alaska State
Troopers at any of the following locations listed on page 4 and 5.
In addition to the Alaska reports, if a state other than Alaska is your primary state of residence you must submit
an equivalent report from your state of residency. Nonresident applicants will need to contact your state law
enforcement office to obtain a complete report of criminal justice information.
If you have lived in Alaska less than one year, please submit the report from your previous state of residence. If
you have lived in Alaska more than one year, but are applying by credential, please submit a report from the
state where you hold your license.
Note: The report of state criminal justice information must come from a law enforcement entity. Internet self
searches will not be accepted. The report must include previous and middle names.
5.
If you are from a state the does not require you to have sixty graduate semester hours in counseling, then
please include a transcript showing you have a minimum of sixty semester hours (obtained either during or after
your counseling degree):
The Board has gone on record with the decision that from June 2011 forward it will issue licenses by
credential only to those applicants who hold licenses to specifically practice professional counseling
from states whose licenses specifically meet or exceed the Alaska state LPC requirements. If licensed
after July 1, 2000, this includes the successful completion of 60 acceptable graduate semester units in
counseling.
6.
If your graduate degree is in a related field, not counseling, you must complete the Educational Course Work
Check Sheet (form 08-4403d).
“Related field” includes psychology, marital and family therapy, social work, and applied behavioral science.
PART II – LICENSURE BY EXAMINATION
The following documentation must be received to be considered for licensure by examination:
1.
A completed and notarized application and $50.00 nonrefundable application fee (form 08-4403).
2.
The initial licensing fee of $275.00 may be submitted at this time or upon successful passage of the
examination. The license will not be issued without payment of this fee.
3.
Certified transcripts of a master’s degree or doctorate degree in counseling or related field as defined in
12 AAC 62.990(b) and regionally accredited from an institution listed under 12 AAC 62.120(a)(1)-(7).
08-4403 ( Rev. 03/04/13)
CONTINUED ON NEXT PAGE
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