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Applications and Forms 

APPLY ONLINE for the following:

Psych Corporate Fictitious Name

To download a paper application, click on the license type you wish to apply for:

Volunteer (PDF)

Application Form for Sponsor/Provider Approval for National and Regional Associations (PDF) 

Reactivation Application

(for EXPIRED or INACTIVE licenses)The reactivation application has been moved to an online process. To review the requirements and submit your reactivation application online login to your account at and click the pencil icon next to your license number to start the reactivation process.