Committee for Social Workers

Change of Address

Please provide the Missouri State Committee for Social Workers with any change in your home address. Please use the form below to report address changes, and click submit.

You must complete the form in its entirety or no changes will be made.

Name as it appears on the certificate
Last Name:
First Name:
Middle Initial:
License Number:
Email:

New Address
Street:
City:
State:
Zip Code:
Telephone Number:

Previous Address
Street:
City:
State:
Zip Code:
Telephone Number:
Or send a quick email to lcsw@pr.mo.gov