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00 LSCSW LMSW LBSW LASW LAC 100. 00 Renewals will not be processed prior to 90 days of expiration date. Signature dated this day of 20 Checklist Please enclose the following LP 200. 00 LCP 175. 00 LMLP 150. 00 LCPC Continuing Education Reporting Form Check Money Order or completed credit card form 175. 00 LCMFT 175. Sam Brownback Governor 700 SW Harrison St. Suite 420 Topeka KS 66603-3929 785 296-3240 Fax 785 296-3112 www. I further understand that it is unlawful to attempt to obtain...
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