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LICENSURE REQUEST FORM Revised January 2015 Virginia Department of Education P. O. Box 2120 Richmond VA 23218-2120 TO DIVISION OF TEACHER EDUCATION AND LICENSURE NAME OF APPLICANT LICENSE NO. APPLICANT ADDRESS Please provide a current accurate mailing address including the zip code for the applicant. Add a degree Bachelor s Master s Education Specialist Juris Doctorate Doctorate Enclose the 25 fee. Enclose the 50 in-state fee or a 75 out-of-state fee. Issue a duplicate license. Enclose the...
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Who needs licensure request form?

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Anyone who wishes to obtain a license or permit for a particular activity or profession needs to fill out a licensure request form.
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Individuals who want to apply for professional licenses, permits, certifications, or registrations may require a licensure request form.
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Various industries such as healthcare, education, finance, construction, and many others may have specific licensure requirements that necessitate filling out a licensure request form.
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Different jurisdictions or government agencies may have their own specific licensure request forms for various purposes.
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It is a form used to request a license to operate a specific business or profession.
Individuals and businesses who wish to obtain a license to operate a particular business or profession are required to file the form.
The form must be completed with accurate and up-to-date information regarding the individual or business seeking the license.
The purpose of the form is to provide necessary information to the licensing authority in order to obtain a license to operate a business or profession.
The form typically requires information such as contact information, business details, qualifications, and any relevant documentation.
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