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Wall Certificate Order Form
Wall Certificate
Please note
This wall certificate is different from the one in your
portal
.
It will take more than three months for you to receive the certificate. They are sent around the state for signatures.
Be sure the mailing address on file with the Board is up-to-date. This is where your certificate will be sent. You can update your mailing address through your
portal
.
Temporary Licensees
You cannot order a wall certificate because
you do not hold a full unrestricted license
.
Would you like a wall certificate?
*
Yes!
Name on Wall Certificate
*
The name that is located in your portal will be used as the name printed on the wall certificate.
I understand!
Where will my certificate be sent?
*
The address located in your portal will be used as the address to send your certificate to.
I understand!
License Number
*
Please provide your license number
Please Note
Certificate orders can take up to three months to receive the certificate. Due to COVID-19 there are delays in certificate orders being mailed to licensees because they’re being mailed around the state to receive the signatures.
Make sure your mailing address is up to date with the Board, so you can receive your wall certificate.
Email (for PDF delivery)
*
Please enter an email address to receive a copy of this completed form.
Payment Information
Payment Options
*
Mail Payment with printed form
PayPal (A $3 fee will be added for online payments)
Mail payment with printed form
*
I understand that if I choose to mail in payment with printed form the Board office will not receive my form submission. I understand that the most common reason for delay is error in completing the form correctly, providing the required information, and not following the instructions. Error can be avoided if you proceed through this form submission carefully, thoroughly, and accurately. If you have any questions or need assistance, call the Board of Examiners at 336-272-1828.
I understand
License Renewal
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*
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Supported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro
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Total
$0.00
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