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Ach the photo. For Office Use Only New Jersey Office of the Attorney General Division of Consumer Affairs State Board of Social Work Examiners 124 Halsey Street, 6th Floor, P.O. Box 45033 Newark, New Jersey 07101 (973) 504-6495 Website: http://www.njconsumeraffairs.gov/social/ Application for Licensure as a Licensed Social Worker Pursuant to N.J.S.A. 45:15BB-6 / N.J.A.C. 13:44G-4.2 Date: A nonrefundable application filing fee of $75, in the form of a check or money order made out to.

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