INSTRUCTIONS FOR COMPLETING SOCIAL WORKER APPLICATION

CAREFULLY READ THESE INSTRUCTIONS. Please TYPE or PRINT all responses except your signature, which should be written. The application, forms and statements must be signed and notarized. If you have the Adobe file it is an active PDF file and you can click on the entry spaces to type your information and print a copy to mail to the Board.

SECTION A: PERSONAL

1. Enter your name as you would like it printed on your license. Be sure to include your social security number.

2. Enter your current mailing address and remember; applicants are obligated to notify the Board of any changes in address.

3. List the phone numbers where you can be reached before and after 5 p.m.

4. This information is requested for statistical purposes.

5. Section 4757.17 of the Ohio Revised Code states that applicants who received degrees from institutions in foreign countries must have "command of the English language." If you have difficulty understanding or using English, you must explain your limitations on a separate sheet.

6. If your name has changed, indicate other names under which documents such as transcripts may be submitted, so that the Board can match your transcript with your application.

7. Provide all professional licensure information in the table provided.

8. A passing score on the appropriate Association of Social Work Boards (ASWB) national examination is a requirement of licensure in Ohio. If taken in another state you must request that your scores be sent to this Board directly from ASWB. Take and pass the exam prior to submitting your licensure application. Attach a photocopy of your passing score to your application.

SECTION B: EDUCATION AND EXPERIENCE

9. Section 4757.01 (D) of the Ohio Revised Code requires that all licensees must be graduates of colleges or universities which are approved by accrediting agencies recognized by the Ohio Board of Regents. In general, these are the major regional accrediting agencies such as the North Central Association of Colleges and Schools, New England Association of Schools and Colleges, Western Association of Schools and Colleges and so on.

10. A master's degree in Social Work is defined as a degree that is accredited by CSWE.

11. Provide names and addresses of institutions from which you have earned an associate, bachelor, master and/or doctoral degree, and the date degrees were awarded. NOTE: Official transcripts (bearing the college or university seal and the Registrar's signature) must be sent directly by the college or university to the Board office. The education requirement for Licensed Social Worker is a bachelor's degree in social work or a degree in a field closely related to social work that was received on or before 10/10/1992. For Licensed Independent Social Worker, the education requirement is a master's degree in social work or a doctorate in social work.


12. Practicums and internships are field work experiences in providing social work services to bona fide clients under the direction of a social work program and for which academic credit is awarded. Scope of practice means duties performed and client population means the type of clients served.

13. Refers to paid professional experience only.

14. Two years of post-masters experience is defined as 3000 hours, except that no more than 1500 hours may be credited in any 12 month period. Post-masters experience obtained before October 10, 1986 must be under the supervision of an MSW or DSW with two years of social work experience, or under a Qualified Mental Health Professional (as defined by the Ohio Department of Mental Health) with two years experience in social work or a closely related field. Post-masters experience obtained after October 10, 1986 must be supervised by a Licensed Independent Social Worker. Any supervision obtained in Ohio after October 10, 1986 must also be post LSW. Each supervisor listed on you application must complete a Licensed Independent Social Worker Employment Reference form included in this packet for that purpose. This form may be duplicated. If you had the same employer for the entire 2 years but changed supervisors, have each supervisor complete a form.

If experience time was obtained out-of-state after 10/10/86, the supervisor must meet the requirements of a MSW or DSW with two years of social work experience and who is not primarily engaged in the private practice of social work as an individual private practitioner or as a member of a partnership or group practice.

15. Only applicants with degrees from programs closely related to social work that were awarded prior to October 10, 1992 will be eligible for licensure. They also must demonstrate that they have coursework totaling 30 quarter or 20 semester hours in three of these five areas. Place the courses you have taken in the appropriate areas. Show department, course number and title, and number of quarter or semester hours of credit. If a course title does not clearly indicate course content, you must provide a copy of the college catalog course description to substantiate the content of the course. All necessary coursework must have been completed prior to October 10, 1992 and have a passing score of "C" or higher. For your guidance, the five areas on the application are defined as follows: (1) HUMAN DEVELOPMENT AND BEHAVIOR: The social, psychological and physiological growth of an indivdual, and effects on the growth of a personality in a social environment; (2) METHODS OF SOCIAL INTERVENTION: Casework, groupwork,community organization and practice, social research and administration; (3) SOCAIL WELFARE AND POLICY: The history of social welfare and policy; (4) SOCIAL WORK THEORY: The study of the principles which demonstrate various types of socio-psychological intervention; (5) FIELD WORK: Not less than 400 hours of supervised practicum and/or field experience, with a primary focus on social intervention, structured or regulated by a department or program in the behavioral or social sciences.

SECTION C: PERSONAL HISTORY INFORMATION/CHARACTER

16-34. All "Yes" answers must be explained in detail on a separate signed and notarized affidavit.

SECTION D: MEMO OF UNDERSTANDING

35. Be sure that all information on this application is correct. The Ohio Revised Code allows the Board to file first degree misdemeanor charges for falsification. Sign your name using your written signature.

SECTION E: AFFIDAVIT

36. The application must be properly notarized before returning it to the Board office. Failure to have the application notarized will result in the application being returned to you.

* Applicants are required to have an official college transcript, showing conferred degree(s), sent directly to the Counselor, Social Worker & Marriage and Family Therapist Board. Student copies are not acceptable.