1 Welcome2 Eligibility3 Contact/Payment Welcome!This online application for the Board Certified Diplomate in Clinical Social Work (BCD) requires no test. It has two parts: A brief eligibility section collecting eligibility information and $350 payment. A more detailed section in which you describe your education, training, and practice, and you name two colleagues to evaluate your practice. In order for this application to be completed, you must fill out all items and finish by clicking the SUBMIT button.Do you work for the Department of Veterans Affairs?*YesNo EligibilityDo you hold a master’s degree in social work with coursework and fieldwork focused on direct practice?*YesNoDo you hold a current state license in clinical social work (if you are a V.A. employee, the V.A. identifies the requisite state license as "advanced practice level".)?*YesNoHave you practiced clinical social work for at least 5 years (7,500 hours) post master's, including 2 years (3,000 hours) under supervision, of which at least 1 year (1,500 hours) was supervised by an Advanced Clinical Social Worker?*Advanced Clinical Social Worker Characteristics - Master’s degree in social work; at least five years of post-graduate clinical social work practice, including two years under clinical supervision; current in practice (3,000 hours in the past 10 years, including at least 300 hours within the past 12 months); licensed in good standing at the highest clinical level available in each state (or jurisdiction) where you practice.YesNoYour response indicates that you are not eligible for this credential. If your response was in error, please correct it so you can continue. Otherwise, you are advised not to try to complete this application, for your money will not be refunded if you are found ineligible. Questions? Please contact email@example.com. All applicants are subject to a random audit of their continuing education and current practice.All applicants are subject to a random audit of their continuing education and current practice. Questions regarding your eligibility? Please contact firstname.lastname@example.org. Name* First Middle Initial Last Preferred Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Daytime Phone*ExtensionEmail*(not va.gov) User Name (Do not use email address)*Password*A strong password is required. Use upper and lowercase letters, numbers and symbols like !”?$%^&). Enter Password Confirm Password Strength indicator BCD Application Fee* Price: $350.00 Testing Discount Price: -$350.00 Total Due $0.00 Accepted Credit Cards* American ExpressMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Security Code Cardholder Name * I understand that $75 of my application fee will be refunded if I am found ineligible for the BCD. However, no refund will be made if I withdraw my application for any reason or if I received unfavorable rating(s) from my Evaluators. Wait a minute for processing after clicking ‘Submit’BCD NumberNameThis field is for validation purposes and should be left unchanged.