New Jersey Ofce of the Attorney General
Division of Consumer Affairs
New Jersey State Board of Architects
124 Halsey Street, 3rd Floor, P.O. Box 45001
Newark, New Jersey 07101
(973) 504-6385
To All Newly Registered Architects:
Please check licensing type:
Initial license by Architect Registration Exam - A.R.E.
Licensure by Credentials - Reciprocity
Please provide your name the way you want it to appear on your wall certicate and seal press. Be advised that a seal will
not be delivered to a P.O. Box.
Name on certicate: _________________________________________________________________________
Name on seal press: _________________________________________________________________________
Current home address: _______________________________________________________________________
City: _______________________________ State: _______________________ ZIP code: _______________
Telephone No.: _______________________ E-mail address: ________________________________________
(includeareacode)
Firm name: ________________________________________________________________________________
Firm address: ______________________________________________________________________________
City: _______________________________ State: _______________________ ZIP code: _______________
Telephone No.: _______________________ E-mail address: ________________________________________
(includeareacode)
Position held: ______________________________________________________________________________
Please provide the address to which all correspondence should be mailed:
Address: __________________________________________________________________________________
City: _______________________________ State: _______________________ ZIP code: _______________
Date: _______________________________ Signature: ____________________________________________
Note: This form must be returned with your licensing fee.
Rev. 11/18
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