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Account Registration

*Note: Membership to this website is verified. Once your account information has been submitted, you will receive an email containing a link that you can use to verify your account. All fields marked with a red asterisk are required. (Note: - Registration may take several seconds. Once you click the Register button please wait until the system responds.)

Email Address:

Enter a valid email address.

Password:

Enter your password.

Confirm Password:

Re-enter the password to confirm.

First Name:

Enter a first name.

Last Name:

Enter a last name.

Street:

Enter the street part of the address. E.g. 123 Main Street

City:

Enter the city part of the address.

State

Choose your state

Telephone:

Enter a telephone number.

Cell/Mobile:

Enter a cell/mobile phone number.

Check the box if you have a current LCSW license

Check the box if you have a current LCSW license.

Check the box if your were designated by NJ as a supervisor

Were you designated by NJ as a Supervisor? If so, please check the box.

Security Code:

Enter the security code.

Enter the code shown above in the box below.

Register to NJSCSW

Account Registration