Passport Sized Recent Head and Shoulder Photo 2 x 2 inches (51 x 51 mm)
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Board records, wall certificate and your seal will reflect first name, middle initial and last name unless another preference is indicated below.

Physical Residence Address

Email

The Board communicates with its licensees by e-mail to include renewal notices.
It is recommended that you provide the Board with two different e-mail addresses, particularly if you use an e-mail address with a .gov, .mil or .edu extension as those will often block e-mail from Constant Contact, which is the company the Board uses for mass e-mails.

Physical Business Address

Mailing Address

Map

Submit an acceptable map.

• Maps should be a simple 18” x 24” single page plat.
• All maps must be from actual surveys and comply with the North Carolina Standards of Practice for Land Surveying (Board Rules).
• It must also comply with G. S. 47-30 (Mapping Requirements for Recordable Maps). For your reference, there is a sample map on the Board’s web site (Sample Map).
• All maps must contain a statement that the fieldwork, calculations and drawing was done by the applicant.
• The applicant’s name must be identified in the statement and signed by a Professional Land Surveyor.
• If after Board review the map needs to be revised, the applicant should cloud, describe and date the revisions.

Exam

Background

1. Have you previously applied for certification or licensure as an SI or PLS in North Carolina?
   Yes

   No
2. Have you previously applied for licensure in any other state and been denied?
   Yes

   No
   You must upload details in PDF format below.
3. Have you ever been disciplined on any professional license?
   Yes

   No
   You must upload details in PDF format below.
4. Have you ever been convicted of a felony?
   Yes

   No
   You must upload proof of restoration of civil rights in PDF format below.
5. Have you ever been convicted of a misdemeanor? (Do not include traffic violations.)
   Yes

   No
   You must upload details in PDF format below.
6. Are you a U.S. citizen?
   Yes

   No
   Provide detailed explanation of legal status in PDF format below.
7. Are you active duty military or a military veteran?
   Yes

   No
8. Are you an active duty military spouse?
   Yes

   No

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