Get 50324 Fill-in.fh11

Navigating the process of applying for licensure as a social worker can be complex. This guide aims to simplify filling out the 50324 Fill-in.FH11 form online, providing clear and supportive instructions to help you accurately complete each section.

Follow the steps to successfully complete your application form.

1. Press the ‘Get Form’ button to access the form and open it in the editor.
2. Carefully read the introductory instructions. Ensure you have all necessary information and documents ready, including your Social Security number and a passport-quality photograph.
3. Complete the applicant information section. Input your full name, current address, and contact details. Include your home and work telephone numbers, email address, and date of birth.
4. Indicate whether you are applying for a temporary permit and if you have previously applied for licensure in Indiana. Provide any previous names used if applicable.
5. Fill out the undergraduate and graduate education section. List all academic institutions attended, including their locations, degree titles, and attendance dates.
6. Document your employment history for the past five years. Include information about each employer, your job title, dates of employment, supervisor's name, and a brief description of your duties.
7. Answer the questions regarding other state licensure or certification history. Provide details about any previous licenses held in different states.
8. Review the questions about any disciplinary actions, denials of licensure, or criminal history. Respond accurately and fully, as these will be important for your application review.
9. Affirm your application by signing and dating the affirmation statement. Complete the authorization for the release of information section as well.
10. If applicable, complete the supervision verification section by having your supervisor fill out their part and ensure they sign it.
11. Finalize your application by reviewing all completed sections for accuracy. Once confirmed, you can save your changes, download a copy, print, or share the form as needed.

Complete your application for licensure online today to ensure a smooth processing experience.