Forms/Applications

Online (web-based) Forms

Relinquish License due to Exemption as AuD

2012 License Renewal Online Application

Request for Invoice to make payment electronically online

Address Change form

Renew Apprenticeship Certificate

Plan of Supervision for Apprenticeship Application

Review Exam

Application for Licensure

PDF Forms for printing and mailing

Complaint Form for submission to Committee on Investigations

Registered Sponsor Application (for Au.D. not licensed by this Board)

Verification of Licensure Form

Application for Apprentice Registration

Application for CEU Program Accreditation

To Become an Authorized Calibrater

Log of Supervision

Report of the Apprenticeship Experience

P.O. Box 97833, Raleigh, NC 27624-7833  -  PH: 919.834.3661  -  FAX: 919.834.3665  - Email: info@nchalb.org