The Board of Psychologist and Psychological Associate Examiners Applications Application for Licensure as a Psychological Associate #08-4362, Revised 05/12/2019 Application for Licensure as a Psychologist by Credentials #08-4313, Revised 05/12/2019 Application for Licensure as a Psychologist by Examination #08-4113, Revised 05/12/2019 Application for Psychologist Courtesy License #08-4230, Revised 12/12/2013 Request for Extension on Supervision Plan #08-4520, Revised 05/10/2013 Request for Alternate Supervision Plan #08-4201, Revised 05/10/2013 Renewal Applications Psychologist License Renewal #08-4238, Revised 04/28/2021 Psychological Associate License Renewal #08-4286, Revised 04/28/2021 Miscellaneous Forms Statement of Supervised Psychological Experience Courtesy Monthly Report Change of Name and/or Address Request for License Verification Form Order a Wall Certificate Credit Card Payment Form