PURPOSE: This rule outlines the procedures for application for licensure as a clinical social worker.

1. (1) Application for clinical social work licensure shall be made on the forms provided by the committee. Application forms shall be obtained from the Executive Director, State Committee for Social Workers, P.O. Box 1335, Jefferson City, MO 65102.
2. (2) An application for licensure is not considered officially filed with the committee until it has been determined by the committee or division staff to be complete and the application is submitted on the form(s) provided by the committee. The application shall be typewritten or printed legibly in black ink, signed, notarized and accompanied by the application fee as set forth in the rules promulgated by the committee.

3. (3) The following documents shall be on file for an application to be considered complete and officially filed:

   1. (A) Completed application;
   2. (B) Official transcript(s) sent directly from the educational institution(s);
   3. (C) Completed Attestation of Clinical Supervision form(s) sent directly from the attesting supervisor(s);
   4. (D) Verification of a passing score as determined by the committee on the clinical examination administered by the Association of Social Work Boards (ASWB). Verification of score(s) shall be sent directly to the committee office by the ASWB; and
   5. (E) Proof of submission of fingerprints to the Missouri State Highway Patrol’s approved vendor for both a Missouri State Highway Patrol and Federal Bureau of Investigation fingerprint background check. Any fees due for fingerprint background checks shall be paid by the applicant directly to the Missouri Highway Patrol or its approved vendor. All fees are nonrefundable.

   6. (F) An applicant for licensure who answers “yes” to any question in the application which relates to possible grounds for denial of licensure under section 337.630, RSMo, shall submit a sworn affidavit setting forth in detail the facts that explain the answer and shall submit copies of appropriate documents related to that answer, if requested by the committee, which shall include but is not limited to the following:

      1. 1. Certified copies of final orders/judg-

ments;

1. 2. If no final order—Certified copy of

clerk’s docket sheet and copy of complaint; and

1. 3. If criminal conviction—A certified

copy of final order and sentence or commutation of sentence.

1. (4) Following the committee’s review process, the applicant will be informed by letter of licensure approval or denial. The denial letter will identify the reasons for denial and the appeal process. 20 CSR 2263-2

AUTHORITY: sections 337.627 and 337.630, RSMo 2000 and 337.600, 337.612, and 337.615, RSMo Supp. 2006.* This rule originally filed as 4 CSR 263-2.050. Original rule filed Sept. 18, 1990, effective Feb. 14, 1991. Amended: Filed Dec. 2, 1991, effective May 14, 1992. Amended: Filed Jan. 11, 1995, effective June 30, 1995. Rescinded and readopted: Filed Dec. 30, 1998, effective July 30, 1999. Amended: Filed Oct. 30, 2002, effective June 30, 2003. Moved to 20 CSR 2263-2.050, effective Aug. 28, 2006. Amended: Filed Dec. 15, 2006, effective June 30, 2007.

*Original authority: 337.600, RSMo 1989, amended 1995, 2003, 2005; 337.612, RSMo 1989, amended 1997, 2001; 337.615, RSMo 1989, amended 1995, 1997, 2001, 2004, 2005, 2006; 337.627, RSMo 1989, amended 1993, 1995, 1997; and 337.630, RSMo 1989, amended 1997.