Maryland Social Work Supervisor Registration Form
This file contains the Maryland Board of Social Work Examiners' Supervision Registration Form for LCSW and LCSW-C. It includes detailed instructions on how to register as a supervisor for LMSW seeking advanced licensure. Additionally, the file provides information about required qualifications, training, and experience.
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How do I fill this out?
To fill out this form, ensure you have all required documents before starting. Follow the provided instructions carefully to avoid any errors. Submit the completed form along with the registration fee.
How to fill out the Maryland Social Work Supervisor Registration Form?
1
Prepare necessary documents and information.
2
Fill in personal details, including name and contact information.
3
Provide your education and licensure details.
4
Complete the section on supervision experience and training.
5
Sign and date the form, then submit with the $20 fee.
Who needs the Maryland Social Work Supervisor Registration Form?
1
Licensed Certified Social Workers (LCSW) who want to become Board-approved supervisors.
2
Licensed Certified Social Worker-Clinical (LCSW-C) aiming to supervise LMSW.
3
Out-of-state licensed social workers seeking recognition in Maryland.
4
LCSW and LCSW-C professionals required by their employer to register as a supervisor.
5
Social workers looking to advance their licensing credentials.
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What are the instructions for submitting this form?
Submit the completed Maryland Social Work Supervisor Registration Form along with a $20 check or money order payable to the Maryland Board of Social Work. Send your submission via mail to Maryland Board of Social Work Examiners, 4201 Patterson Avenue, Baltimore, MD 21215-2299. For additional assistance, contact the Board office at 410-764-4788 or toll free at 1-877-526-2541. Ensure all signatures are in blue ink and all required documents are attached.
What are the important dates for this form in 2024 and 2025?
Important deadlines for submitting the Maryland Social Work Supervisor Registration Form in 2024 and 2025 are primarily related to professional licensing cycles. Ensure to verify specific submission dates with the Maryland Board of Social Work Examiners.
What is the purpose of this form?
The Maryland Social Work Supervisor Registration Form is designed to facilitate the registration of qualified Licensed Certified Social Workers (LCSW) and Licensed Certified Social Worker-Clinical (LCSW-C) as Board-approved supervisors. This form ensures that supervisors meet the requisite educational and experiential criteria to provide guidance and oversight to Licensed Graduate Social Workers (LMSW) seeking advanced licensure. Additionally, the form establishes a standardized procedure for documenting supervision qualifications, thereby maintaining the integrity and professionalism of social work practice in Maryland.
Tell me about this form and its components and fields line-by-line.
- 1. Name: Enter your legal name, which will appear on all documents.
- 2. Contact Information: Provide your postal address, phone numbers, and email address.
- 3. Race / Ethnic Identification: Select your race or ethnic identification from the provided options.
- 4. Education: List the year your MSW degree was conferred, the university, city, and state.
- 5. Licenses Held: List your Maryland social work license and any other state licenses held.
- 6. Training: Attach documents verifying your completion of academic courses or continuing education in social work supervision.
- 7. Experience: Detail your employment experience relevant to the supervision qualifications.
- 8. Current Employment: Provide information about your current employer or solo practice, including the starting date and position.
- 9. Licensee's Affidavit: Sign and date the form with an original signature in blue ink.
- 10. Payment Information: Submit a check or money order for the registration fee payable to the Maryland Board of Social Work.
What happens if I fail to submit this form?
Failure to submit the form accurately and on time could result in delays or denial of your supervisor registration.
- Delays in Approval: Late submissions may delay the approval process for becoming a registered supervisor.
- Non-Refundable Fee: The $20 registration fee is non-refundable, meaning any errors could result in additional costs.
- Professional Implications: Failing to register could impact your ability to supervise LMSWs and affect your professional responsibilities.
How do I know when to use this form?
- 1. Becoming a Supervisor: Register to provide supervision to LMSWs seeking advanced licensure.
- 2. Meeting Employer Requirements: Complete this form if your employer mandates registration as a supervisor.
- 3. Out-of-State Social Workers: Out-of-state licensed social workers must use this form for recognition in Maryland.
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