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For individuals seeking to become Licensed Professional Counselor Associates (LPCAs) in North Carolina, the NC BLPC form serves as an essential first step in the licensure process. This application is designed specifically for new graduates, providing a detailed checklist to ensure that all necessary components are thoroughly completed. It encompasses a range of requirements, from basic personal information, such as social security number and date of birth, to more complex documentation regarding one’s educational history, professional references, and counseling experiences. This thorough process demands that applicants list all relevant licenses and certificates and provide a written explanation for any answered “Yes” in the legal and ethics history section. Additionally, one must submit official transcripts directly from their graduate institutions, along with a description of their practicum and internship experiences. Security measures play a key role, demanding fingerprint cards and an authorization for background checks. Each section of the form has specific instructions to guide applicants through the submission process effectively. The application fee, which combines an administrative fee with costs associated with background checks, must accompany the application. Overall, the NC BLPC form reflects a commitment to ensuring that those entering the counseling profession are well-qualified, ethical, and prepared to serve their communities.

Nc Blpc Example

North Carolina Board of Licensed Professional Counselors

LPC Associate Licensure Application

Pre-requisite for LPC license for new graduates

Checklist for LPCA Applicants

I have read the Application Process for LPCAs.

I have completed all of Section I. Social Security Number and Date of Birth are required.

I have listed all licenses and certificates that I hold issued in North Carolina and other states in Section II.

I have enclosed a written explanation for questions answered with a “Yes” in

Section III — Legal and Ethics History.

I have listed all graduate institutions attended in Section IV and have requested transcripts to be sent directly to the NCBLPC.

I have listed three (3) professional references with contact information and the length of time I have known them in Section V.

I have listed my graduate counseling experience (practicum and internship) in Section VI and I have requested that a faculty member in my university counseling department complete the Verification of Graduate Counseling Experience form to be sent directly to the NCBLPC.

I have listed my graduate course work with course codes and semester or quarter hours in Section VII.

I have attached a photo (no larger than 2“ x 2”), signed and dated the application and have had my application notarized in Section VIII.

I have signed and dated the application in the presence of a Notary Public and have had my application notarized in Section IX.

I have enclosed two fingerprint cards and the Authority for Release of Information (see page 11) to be submitted by the NCBLPC for state and national background checks to be performed by the SBI and FBI as required in Section XII.

I have included my application fee of $238, includes fee for criminal background check

I have included my LPCA Professional Disclosure Statement.

I have included my LPCA Jurisprudence Exam Certificate of Completion.

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Application Page 1 of 10

Revised 03/25/14

North Carolina Board of Licensed Professional Counselors

Licensure Application

Licensed Professional Counselor Associate

Pre-requisite for LPC license for new graduates

APPLICATION INSTRUCTIONS

1.PRINT or TYPE using BLACK Ink to complete this application.

2.Applicants must complete ALL SECTIONS. Read carefully.

3.A completed application and other required support documentation are to be mailed in one packet to the Board’s address.

4.The application fee is $200 plus an additional $38 for the criminal background check and must accompany the application when mailed. Application fees are non-refundable.

I. GENERAL INFORMATION - To be completed by all applicants.

 

Name (Last, First, Middle):

Social Security Number:

Date of Birth:

___________________________________________

______________________

______________________

 

(required)

(mm/dd/yyyy)

Please include maiden name and/or any other alias:

 

 

________________________________________________

 

Mailing Address (Street and/or Box Number, City, State, Zip Code):

Home Phone:

__________________________________________________________

_________________________

Email Address:

 

Mobile Phone:

___________________________________________________________

_________________________

Business Name & Address (is this an exempt setting, such as a school, university or government agency)?: Yes No

_________________________________________________

Work Phone:

_________________________________________________

_________________________

_________________________________________________

 

Email Address:

Work Fax:

_________________________________________________

_________________________

II.CREDENTIALS - To be completed by all applicants, if applicable.

List all professional credentials which you now hold or have ever held in order of attainment.

License/Certificate Type

License/Certificate # Issued Date

Issued By

Amount $

Payment: CC Check MO

For Office Use Only Date Rec’d:

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Name of Applicant: (Required)

III.LEGAL & ETHICS HISTORY - To be completed by all applicants. All applicants are REQUIRED to submit two

(2) fingerprint cards, the Authorization for Release of Information and payment of $38 to the NCBLPC for a state and national background check to be performed.

1.Have you ever been denied the privilege of taking an occupational licensure or certification examination? If yes, state what type of occupational examination, where, and provide final written decision from the denying Board on a separate sheet of paper.

2.Have you ever had any disciplinary action taken against an occupational license or certificate to practice or are any such actions pending? If yes, explain in detail on a separate sheet of paper.

3.Have you ever been convicted of a violation of/or pled nolo contend ere to any federal, state, or local statute, regulation or ordinance or entered into any plea bargain for violations, except for minor traffic violations? If yes, see below.**

4.Within the past four years, have you been unable to engage in the practice of counseling due to a physical and/or emotional dependency or use of alcohol and/or drugs? If yes, please provide a letter from your treating professional summarizing diagnosis, treatment and prognosis.

5.Within the past four years, have you been unable to engage in the practice of counseling due to treatment and/or hospitalization for a nervous, emotional or mental disorder? If yes, please provide a letter from your treating professional summarizing diagnosis, treatment and prognosis.

6.Have you ever been censured, warned, or requested to withdraw from your practice/employment, terminated from any health care facility, agency, or practice for reasons involving your conduct as a counselor? If yes, please provide an explanation on a separate sheet of paper.

7.Have you ever been convicted of an offense involving the taking of illegal drugs or the consumption of alcohol? If yes, see below.**

If you answered YES to questions 3 and/or 7, you must submit:

1)A written explanation of the event(s).

2)A written explanation on how you have dealt with the circumstances that lead up to the event(s).

1.

Yes No

2.

Yes No

3.

Yes No

4.

Yes No

5.

Yes No

6.

Yes No

7.

Yes No

IV. EDUCATION - To be completed by all applicants. Official Graduate Transcripts from each of the Universities listed below must be submitted directly to the NCBLPC Board Office from the Graduate Institution.

Graduate Institution

(Undergraduate Not Required)

Dates of Attendance

From To

Major/Degree Received

Date Degree

 

Conferred

V. REFERENCES - To be completed by all applicants. Please list three individuals (may include supervisors) who are acquainted with your professional counseling work.

Name, Address, & Phone

Title

Yrs Known

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Name of Applicant: (Required)

VI. Graduate Counseling Experience - To be completed by all applicants. List below your graduate Practicum and Internship experiences (use additional sheets if necessary). These experiences should appear on your graduate transcript(s). Send Verification of Graduate Counseling Experience form(s) to your University. A faculty member/university supervisor should complete the form and send it directly to the NCBLPC. Practicum and Internship are defined in Rule .0701(B).

1. Dates of

Practicum

Total # of weeks:

 

 

 

# of hours per week:

 

 

 

From:

 

 

To:

Course # and Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Graduate Institution:

 

 

 

University Supervisor:

 

 

 

Practicum/Internship Site:

 

 

 

Site Supervisor:

 

 

 

Position Held/Responsibilities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Dates of

Practicum

Total # of weeks:

 

 

 

# of hours per week:

 

 

 

From:

 

 

To:

Course # and Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Graduate Institution:

 

 

 

University Supervisor:

 

 

 

Practicum/Internship Site:

 

 

 

Site Supervisor:

 

 

 

Position Held/Responsibilities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Dates of

Internship

Total # of weeks:

 

 

 

# of hours per week:

 

 

 

From:

 

 

To:

Course # and Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Graduate Institution:

 

 

 

University Supervisor:

 

 

 

Practicum/Internship Site:

 

 

 

Site Supervisor:

 

 

 

Position Held/Responsibilities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. Dates of

Internship

Total # of weeks:

 

 

 

# of hours per week:

 

 

From:

 

 

To:

Course # and Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Graduate Institution:

 

 

 

University Supervisor:

 

 

Practicum/Internship Site:

 

 

 

Site Supervisor:

 

 

Position Held/Responsibilities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This version supersedes all previous versions

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Name of Applicant: (Required)

VII GRADUATE COURSES - To be completed by all applicants. Course areas are fully defined in Rule .0701 of the Administrative Code and are posted on the Board website. In cases where the course title does not clearly reflect course content, applicants shall provide university course descriptions and/or syllabi for clarification. Each course area must have at least one 3-semester hour (or 5 quarter hour) course unless otherwise specified.

A.HELPING RELATIONSHIPS IN COUNSELING - shall provide a general knowledge of theories, their principles, and techniques for application in counseling relationships; shall include crisis intervention and suicide prevention models.

Course Code

Date Completed

Title

Sem/Qtr hrs

B.PROFESSIONAL ORIENTATION TO COUNSELING - shall provide an understanding of all aspects of functioning as a professional counselor, including a history of the counseling profession, various roles contemporary counselors have in our society, membership in professional counseling associations, self-care strategies appropriate to the counselor role, ethical conduct, standards of preparation, credentialing processes, and counseling supervision models, practices, and processes.

Course Code

Date Completed

Title

Sem/Qtr Hrs

C-1. PRACTICUM IN COUNSELING - Applicant’s must have both a Practicum and an Internship as defined in Rule .0206. Coursework shall be provided in a university-approved counseling setting for at minimum one (1) semester duration (three semester hours or 5 quarter hours of credit) for Practicum and one (1) semester duration for Internship of academic credit in a regionally accredited program of study.

Course Code

Date Completed

Title

Sem/Qtr Hrs

C-2. INTERNSHIP IN COUNSELING - Applicant’s must have both a Practicum and an Internship as defined in Rule .0206. Coursework shall be provided in a university-approved counseling setting for at minimum one (1) semester duration (three semester hours or 5 quarter hours of credit)for Practicum and one (1) semester duration for Internship of academic credit in a regionally accredited program of study.

Course Code

Date Completed

Title

Sem/Qtr Hrs

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Name of Applicant: (Required)

VII. GRADUATE COURSES (continued) - To be completed by all applicants. Course areas are fully defined in

Rule .0701 of the Administrative Code and are posted on the Board website. In cases where the course title does not clearly reflect course content, applicants shall provide university course descriptions and/or syllabi for clarification. Each course area must have at least one 3-semester hour (or 5 quarter hour) course unless otherwise specified.

D.ASSESSMENT IN COUNSELING - shall include studies that provide a broad understanding of historical perspectives concerning the nature and meaning of assessment as well as basic concepts of standardized and non-standardized testing and other assessment techniques.

Course Code

Date Completed

Title

Sem/Qtr Hrs

E.CAREER COUNSELING AND LIFESTYLE DEVELOPMENT - shall include studies that provide a broad understanding of career development theories and decision-making models as well as career and educational planning, placement, follow- up, and evaluation.

Course Code

Date Completed

Title

Sem/Qtr Hrs

F.GROUP COUNSELING THEORIES AND PROCESSES - shall include studies that provide a broad understanding of group development, dynamics, methods, and counseling theories; shall help students understand group leadership styles, basic and advanced group skills, and other aspects of group counseling and group consultation.

Course Code

Date Completed

Title

Sem/Qtr Hrs

G.HUMAN GROWTH AND DEVELOPMENT THEORIES IN COUNSELING - shall provide a broad understanding of human behavior, including an understanding of developmental crises, disability, psychopathology, and situational and environmental factors that affect both normal and abnormal behavior.

Course Code

Date Completed

Title

Sem/Qtr Hrs

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Application Page 6 of 10

Revised 03/25/14

Name of Applicant: (Required)

VII. GRADUATE COURSES (continued) - To be completed by all applicants. Course areas are fully defined in

Rule .0701 of the Administrative Code and are posted on the Board website. In cases where the course title does not clearly reflect course content, applicants shall provide university course descriptions and/or syllabi for clarification. Each course area must have at least one 3-semester hour (or 5 quarter hour) course unless otherwise specified.

H.RESEARCH AND PROGRAM EVALUATION - shall include studies that provide a broad understanding of the importance of research in advancing the counseling profession; study of research methodology, statistical methods, the use of research to inform evidence-based practice; and ethical and culturally relevant strategies for interpreting and reporting the results of research and/or program evaluation studies.

Course Code

Date Completed

Title

Sem/Qtr Hrs

I.SOCIAL AND CULTURAL FOUNDATIONS IN COUNSELING - shall provide an understanding of theories of multicultural counseling, identity development, and social justice while examining multicultural and pluralistic trends, including characteristics and concerns within and among diverse groups nationally and internationally.

Course Code

Date Completed

Title

Sem/Qtr Hrs

This version supersedes all previous versions

Application Page 7 of 10

Revised 03/25/14

Name of Applicant: (Required)

VIII. PHOTO

Please attach a passport size photo

with tape on each side

Photo should be no larger than 2” x 2”

IX. APPLICATION VALIDATON - To be completed by all applicants. The following statement must be signed in the presence of a Notary Public. This application is not valid unless properly signed and notarized. Note: Any false or misleading information in, or in connection with, any application may be cause for denial of application.

The undersigned, being sworn (or affirmed), deposes and says that he/she is the person who executed this application; that the statements herein contained are true in every aspect; that he/she will conform to the ethical standards and standards of practice in his/her professional conduct; that he/she has read and understands this affidavit.

The undersigned also understands that the Board has the authority to conduct a full criminal record search, including state and national records.

Applicant’s Full Name (PRINTED):

Applicant’s Signature:

Notary Information:

State of

 

 

 

 

 

 

 

City/County of

 

 

 

 

 

 

Sworn to (or affirmed) and subscribed before me,

 

 

 

on this, the

 

day of

, 20

 

SEAL

 

 

 

 

 

 

 

 

Notary Public:

My Commission Expires:

The NCBLPC is charged with the responsibility of reviewing and acting on the applications of qualified persons who are adequately prepared in professional counseling. The Board has no jurisdiction over professions or professionals prepared in other fields that are licensed/certified by other Boards such as Marriage & Family Therapy, Psychology, Fee-Based Pastoral Counseling, Substance Abuse and Social Work.

Mail completed application to: NCBLPC ♦ PO Box 1369 ♦ Garner, NC 27529

This version supersedes all previous versions

Application Page 8 of 10

Revised 03/25/14

X. Criminal Background Information

Instructions for Completing the Applicant Fingerprint Card

Please go to your local law enforcement agency (police department or sheriff’s office) and request that they make two fingerprint cards. The bearer of this letter is seeking to obtain a copy of his or her criminal history record information for pursuant to NCGS 90-345(b) in order to obtain a license from the North Carolina Board of Licensed Professional Counselors.

1.The complete name of the subject is to be listed as indicated: last name, first name, and middle name. Please ensure the name is legible if written.

2.List any and all alias names or nicknames, maiden name, or any other married names.

3.Sex is to be listed as M for Male and F for Female or U for Unknown.

4.Race is to be listed by placing an individual into one (1) of the following categories by writing the appropriate letter in

the space provided. W – White

B – Black

I – American Indian or Alaskan Native A – Asian or Pacific Islander

U – Unknown if unsure or unable to determine

5.Indicate the subject’s height in feet and inches using all numeric.

Example: 6’01’ = 601, 6’11” = 611, 6’ = 600

6.Indicate the subject’s weight in pounds using all numeric.

Example: 186 or 098, etc.

7.List the subject’s eye color by placing one (1) of the following eye color codes in the space provided:

BLK—Black GRY—Gray MAR—Maroon BLU—Blue GRN—Green PNK—Pink BRO—Brown HAZ—Hazel XXX—Unknown

8.Color of hair should be indicated by writing one (1) of the following color codes in the space provided: BAL – Bald (when subject has lost most of his hair or is hairless)

BLK – Black

BLN – Blond or Strawberry BRO – Brown

GRY – Gray or partially RED – Red or Auburn SDY – Sandy

9.List the date of birth numerically– month, day and year

Example: May 11, 1948 should be shown as 05111948

10.Indicate, if possible, the city and state where the subject was born. The state should be indicated by the two letter abbreviation.

11.OCA block: NCBLPC000

12.Social Security: write in the Social Security Number

13.Residence of Person Fingerprinted: Current residence of subject fingerprinted is written here.

14.Employer Board Address: NC Board of Licensed Professional Counselors, PO Box 1369, Garner NC 27529

15.Reason Fingerprinted: Licensed Professional Counselor per NCGS 90-345, state and federal.

This version supersedes all previous versions

Application Page 9 of 10

Revised 03/25/14

XI. Authority for Release for Criminal Background Check

AUTHORITY FOR RELEASE OF INFORMATION

State and Federal Record Check

I authorize the North Carolina Department of Justice through the State Bureau of Investigation, Special

Operations Division, to perform a fingerprint search of the State’s criminal history record file and a fingerprint search of the Federal Bureau of Investigation’s files for a national criminial history record check in connection

with my application for licensure with the North Carolina Board of Licensed Professional Counselors pursuant to NCGS 90-345.

Please type or print clearly; use only black or blue ink.

________________________

_________________________

___________________________

Last Name

First Name

Middle Name

________________________

 

 

 

Maiden Name

 

 

 

________________________

_________________________

_________

_______________

Social Security Number

Date of Birth

Gender

Race

(Optional*)

 

 

 

I understand that the North Carolina State Bureau of Investigation, Special Operations Division, and its officials and employees shall not be held legally accountable in any way for providing this information to the North Carolina Board of Licensed Professional Counselors, and I hereby release said agency and persons from any and all liability which may be incurred as a result of furnishing such information. I further understand that the North Carolina Board of Licensed Professional Counselors cannot provide the results of this criminal history record check to me.

*Disclosure of a social security number is entirely voluntary and not required. If disclosed, the social security number will be utilized to assist with accurate identification/exlusion of possible criminal history checks.

________________________________________________

____________________________

Signature of Applicant

Date

The Authority for Release of Information, the fingerprint card(s) and the fee must be mailed to:

NCBLPC

PO BOX 1369

Garner NC 27529

ORI # NCBC10000 – North Carolina Board of Licensed Professional Counselors

This request form must be maintained on file with the above named agency for one year.

Do not mail this form or a copy of this form

to the State Bureau of Investigation.

This version supersedes all previous versions

Application Page 10 of 10

Revised 03/25/14
Get Nc Blpc PDF Form

Form Characteristics

Fact Name Details
Governing Body North Carolina Board of Licensed Professional Counselors (NCBLPC)
Application Purpose To apply for LPC Associate Licensure, essential for new graduates seeking LPC license.
Application Fee The total fee is $238, which includes the criminal background check.
Required Sections All sections of the application must be completed. Each contains specific instructions.
Notarization Requirement The application must be signed in the presence of a Notary Public.
Background Check Applicants must submit two fingerprint cards and an Authorization for Release of Information.
Professional References Three professional references are required, including contact information and duration of acquaintance.
Transcripts Requirement Official graduate transcripts must be sent directly by the institutions to the NCBLPC.
Legal and Ethics Disclosure A written explanation is necessary for any "Yes" answers in the Legal and Ethics History section.

Guidelines on Utilizing Nc Blpc

Filling out the NC BLPC form is an important step toward achieving your LPC Associate Licensure. It is essential to complete each section carefully to ensure your application is processed efficiently. Below are the steps to help guide you through this process.

  1. Print or type your information using black ink.
  2. Complete all sections of the application form, paying close attention to detail.
  3. In Section I, provide your personal information, including your name, social security number, date of birth, mailing address, and contact numbers. This information is required.
  4. In Section II, list all professional licenses and certificates you have held, along with their details.
  5. For Section III, address any legal and ethics history questions honestly, and attach written explanations for any “Yes” responses.
  6. In Section IV, list all the graduate institutions you attended and request that your transcripts be sent directly to the NCBLPC.
  7. In Section V, list three professional references with their contact details and how long you have known them.
  8. In Section VI, document your graduate counseling experience, ensuring that a faculty member completes the Verification of Graduate Counseling Experience form and sends it directly to the NCBLPC.
  9. In Section VII, record your graduate coursework, including course codes and hours completed.
  10. Attach a recent photo that is no larger than 2” x 2”.
  11. Sign and date the application in the presence of a Notary Public, and ensure the application is notarized.
  12. Include two fingerprint cards and the Authority for Release of Information for background checks.
  13. Enclose your application fee of $238, which includes the fee for the criminal background check.
  14. Attach your LPCA Professional Disclosure Statement and LPCA Jurisprudence Exam Certificate of Completion.
  15. Mail all documents in one complete packet to the NCBLPC’s address.

What You Should Know About This Form

What is the NC BLPC form?

The NC BLPC form is the application for Licensed Professional Counselor Associate (LPCA) licensure in North Carolina. It is designed for new graduates seeking to obtain a license that allows them to practice as counselors under supervision while completing the required post-graduate experience.

Who needs to complete the NC BLPC form?

All individuals who have completed their graduate coursework in counseling and wish to become Licensed Professional Counselors in North Carolina must complete the NC BLPC form. This includes those looking for LPCA status as a prerequisite for obtaining an LPC license.

What documents must be submitted with the application?

Applicants must submit several key documents along with the completed NC BLPC form. These include official graduate transcripts, professional references, a photo, fingerprint cards, a criminal background check authorization, and the application fee. Additionally, the LPCA Professional Disclosure Statement and the LPCA Jurisprudence Exam Certificate of Completion are necessary.

How much is the application fee?

The total application fee is $238. This includes a $200 processing fee and an additional $38 for the required criminal background check. Fees must accompany the application and are non-refundable.

What information is needed in Section III - Legal & Ethics History?

In Section III, applicants must disclose any past or pending legal or ethical issues related to their professional practice. This includes any disciplinary actions against professional licenses, criminal convictions, or issues of substance abuse that may affect their ability to practice. If you answer "yes" to certain questions, you must provide a written explanation.

Are there specific requirements for the professional references?

Yes, applicants need to list three professional references who are familiar with their counseling work. It is important that these individuals can speak to the applicant's qualifications and ethical practices. Their contact information and the duration of acquaintance must also be included.

Is notarization required for the application?

Yes, applicants must have their application notarized. This involves signing and dating the application in the presence of a Notary Public, ensuring that all provided information is accurate and verifiable.

How should transcripts be submitted?

Official graduate transcripts must be sent directly to the North Carolina Board of Licensed Professional Counselors from the educational institutions attended by the applicant. Applicants should request this in advance to ensure timely processing of their applications.

What are the consequences of submitting an incomplete application?

Submitting an incomplete application may result in delays in processing or outright rejection of the application. It is crucial for applicants to review the checklist thoroughly and ensure that all required documentation is included before submission.

Common mistakes

Filling out the North Carolina Board of Licensed Professional Counselors (NCBLPC) Form can be a detailed process, and mistakes can lead to delays or rejections. One common mistake is failing to read the Application Process for LPCAs. Understanding the entire procedure is crucial as it highlights essential requirements and documents needed for submission. Skipping this step can result in overlooked information.

Another frequent error involves incomplete sections. Each part of the application must be completed accurately. Applicants often forget to provide their Social Security Number or date of birth, which are mandatory fields. Inadequate information may lead to processing delays and additional requests for clarification.

Not documenting previous licenses and certifications correctly is a significant oversight. Section II requires listing all credentials from North Carolina and other states. Applicants sometimes omit relevant licenses or provide incorrect details which can create complications later in the verification process.

A proper response to the Legal and Ethics History questions in Section III is vital. Failing to provide written explanations for any affirmative answers can be detrimental. Applicants must ensure they detail any experiences that may affect their eligibility, as this information is thoroughly reviewed during the application process.

Many applicants also overlook the importance of gathering and submitting transcripts from their graduate institutions. Section IV clearly states that transcripts must be sent directly to the NCBLPC. Not adhering to this requirement can result in a pending application while waiting for documents to arrive.

Providing incorrect or outdated information for professional references is another mistake. In Section V, including how long one has known their references is essential. Failure to do so can complicate background checks and reference verifications.

Some applicants forget to request a Verification of Graduate Counseling Experience form to be completed by a faculty member. This is critical for Section VI, which confirms practical experience. Without it, the application may be deemed incomplete.

Section VII requires detailed course listings, and many applicants fail to provide course codes and credit hours. Moreover, not attaching supporting syllabi or course descriptions can hinder understanding and approval.

An additional mistake involves forgetting to attach a recent photo and notarizing the application as required in Sections VIII and IX. Notarization is a legal requirement that many underestimate, leading to automatic disqualifications.

Finally, when submitting the application fee, errors can occur. Applicants often confuse the required amount. Thus, it’s essential to ensure that both the application fee and any additional fees, such as those for a background check, are included and tracked accurately to avoid a delay in processing the application.

Documents used along the form

The North Carolina Board of Licensed Professional Counselors (NCBLPC) LPC Associate Licensure Application, referred to as the NC Blpc form, is essential for new graduates seeking licensure. Alongside this application, several other forms and documents are often necessary to facilitate the licensure process. Below is a list of common documents to include with your application. Each item is designed to gather important information about your credentials, background, and qualifications.

  • Verification of Graduate Counseling Experience Form: This document requires your university faculty member to confirm your practicum and internship experiences, ensuring you meet the required educational standards.
  • Application Fee Payment Receipt: You'll need proof of your application fee payment, which covers processing and background checks. The total is typically $238, including the necessary background check fees.
  • Professional Disclosure Statement: This form outlines your professional background, including your qualifications and any specialties you may have. It helps provide transparency to your clients.
  • Jurisprudence Exam Certificate of Completion: You must pass this exam, which tests your knowledge of relevant laws, ethical standards, and regulations governing counseling practices in North Carolina.
  • Authorization for Release of Information: Required for state and national background checks, this form allows the NCBLPC to obtain your criminal history from various databases.
  • Fingerprints Card: Two fingerprint cards are necessary for conducting background checks through the State Bureau of Investigation (SBI) and the Federal Bureau of Investigation (FBI).
  • Transcripts from Graduate Institutions: Official transcripts must be sent directly from each university you attended, confirming your educational qualifications and the degrees earned.
  • References List: It is important to include a list of professional references who can vouch for your counseling experience and character. Typically, three references are required.

Gathering and submitting these additional forms along with the NC Blpc form will help ensure a smooth application process. Proper completion and timely submission will allow for timely review and approval by the NCBLPC.

Similar forms

The NC BLPC form serves as a critical document for aspiring Licensed Professional Counselor Associates in North Carolina. Several other documents encompass similar features and purposes. Here are five documents that align with the NC BLPC form:

  • LPC Licensure Application: Like the NC BLPC form, this application is a prerequisite for obtaining a full LPC license. It requires applicants to provide personal information, academic history, professional references, and details about their counseling experience.
  • Credential Verification Form: This document is utilized to verify the educational and professional credentials of applicants, much like the NC BLPC form's requirement for a list of licenses and transcripts from institutions attended.
  • Professional Disclosure Statement: Similar to the LPCA Professional Disclosure Statement attached to the NC BLPC application, this document outlines the counselor's qualifications, treatment approaches, and confidentiality agreements, ensuring transparency with clients.
  • Background Check Authorization Form: As with the fingerprint card requirement in the NC BLPC form, this form authorizes background checks to ensure the applicant meets ethical standards for practicing counseling.
  • Verification of Graduate Counseling Experience Form: Both the NC BLPC form and this verification form seek confirmation of practical counseling experiences, requiring details about the nature and duration of the applicant's practicum and internship work.

Dos and Don'ts

Things to Do:

  • Read the Application Process for LPCAs carefully before starting.
  • Complete all required sections, including your Social Security Number and Date of Birth.
  • Request official transcripts from all graduate institutions to be sent directly to the NCBLPC.
  • List three professional references along with their contact information.
  • Request transcripts and verification forms from your university counseling department in a timely manner.
  • Ensure that your application fee is included and clearly marked as payment for processing.

Things to Avoid:

  • Do not leave any required sections incomplete.
  • Avoid submitting documentation separately from the application; everything must be mailed in one packet.
  • Do not forget to attach the finger print cards and Authority for Release of Information.
  • Refrain from using any ink color other than black when filling out the application.
  • Do not skip questions about legal and ethics history; provide detailed explanations where necessary.
  • Never submit a photo larger than the specified 2" x 2" size.

Misconceptions

Here are some common misconceptions about the North Carolina Board of Licensed Professional Counselors (NCBLPC) LPC Associate Licensure Application (Nc Blpc form):

  • Misconception 1: The application process is only for new graduates.

    • While the application is indeed designed for new graduates seeking an LPC Associate license, it can also serve individuals who are transitioning from other states or seeking to reinstate a lapsed license.

  • Misconception 2: All sections of the application can be left blank if they don't apply.

    • Applicants must complete all sections of the application. Each section plays a crucial role in determining eligibility, so skipping sections is not permitted.

  • Misconception 3: The application fee is refundable.

    • The application fee of $200, plus an additional $38 for the criminal background check, is non-refundable. It’s important for applicants to ensure they meet all requirements before submitting.

  • Misconception 4: Submitting fingerprints and background checks is optional.

    • Submitting two fingerprint cards along with the Authorization for Release of Information is a mandatory part of the process. Background checks are essential for determining an applicant’s suitability for licensure.

Key takeaways

  • Read the Application Process: Familiarize yourself with the entire application process for Licensed Professional Counselor Associates (LPCAs) before starting.
  • Complete All Sections: Fill out all required sections of the NC BLPC form. Do not skip any parts.
  • Provide Accurate Personal Information: Ensure that your Social Security Number and Date of Birth are accurate and included in Section I.
  • Document Your Experience: Clearly list all relevant graduate counseling experiences, including practicum and internship details, in Section VI.
  • Gather Required Supporting Documents: Collect and send all supporting documents, including transcripts and reference letters, to the NCBLPC.
  • Fingerprint Cards are Mandatory: Include two fingerprint cards and the necessary authorization for background checks as outlined in Section XII.
  • Application Fee Compliance: Ensure the application fee of $238 accompanies your packet, as fees are non-refundable.
  • Sign and Notarize: Remember to sign and notarize your application. This step is crucial for the validity of your submission.

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