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 the Mailed Payment submission will not be received by the Board. I understand that I will need to print off the PDF emailed to me and send it with my check or money order.
- I understand!
License Renewal
Payment Method*

American Express
Discover
MasterCard
Visa
Maestro
Supported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00
Instructions: Mail Payment with Printed Form

Upon submission of this form, an email will be sent to the address provided above. The email will contain an attached PDF and a link to a PDF of the form you completed. If paying with check or money order, print off the PDF and mail it with your payment.

Checks/money orders are made payable to NCBOESLPA, and should be mailed to:
NCBOESLPA
PO Box 16885
Greensboro, NC 27416

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Wall Certificate

Please note

Temporary Licensees

Please Note

Payment Information

Instructions: Mail Payment with Printed Form

Licensees