Application Forms

Please submit any and all completed application forms to

Professional License/Member-In-Training

PLEASE NOTE: All application forms include an overview of the Competency-Based Assessment (CBA) model, which is the mandatory experience review component to becoming licensed with PEGNL. All new applications for professional licensure MUST include a completed CBA file in order to be considered. (This does not apply to transfer applicants(. All those applying to become a Member-In-Training will not need a completed CBA file to apply, but WILL need to have one when applying to upgrade to a professional licensed member.

To learn more about CBA, including information on how to begin your CBA file, please click HERE. You can also learn more from our overview video.

If, and only if, you are an existing Members-In-Training who registered with PEGNL on or before September 1, 2019, you may choose to use the previous application method and experience review process. If so, please use the link below to find the application form and summary of work experience document.

Permit To Practice

Limited License