NCBA/RID Online Registration Application

Instructions

• You may only complete this application if you have a current NCIDQ certificate.
• Rules and laws are available on the Board’s website at www.ncbarch.org
  governing the practice of architecture and registered interior design in North Carolina.
  They are found at www.ncbarch.org in the rules and laws section.
• You are required to notify the Board of all contact information changes, including
  name changes. ALL correspondence from NCBA/RID will be via email.
• Upon approval of registration, notification will be sent to your email address on this application.

Name -

^*First:

Middle

^*Last

Suffix

^*Mailing Address 1

Address 2

^*City

^*State

^*Zip

^*Home Phone

Bus. Phone

Mobile

^*Email

^*SSN

^*Birth Date

^*Place of Birth

^*NCIDQ ID

Projects/Services

IMPORTANT:
If you have NOT offered or rendered registered interior design services in the State of North Carolina please certify below.

I certify that I have NOT offered or rendered interior design services in the State of North Carolina as a registered interior designer.

If you have offered and rendered registered interior design services in the State of North Carolina, specify the current status of the project, project location and owner name.

IMPORTANT:
• Please Read - Instructions about criminal, disciplinary and employment related questions.

I hereby apply for Registration to practice Interior Design. My NCIDQ Certificate is current and in good standing. I understand that revocation of the NCIDQ certificate by CIDQ shall automatically terminate my registration to practice in North Carolina until such time as the certificate is reinstated by CIDQ.

I hereby certify that I have read the laws and rules governing the practice of registered interior design in North Carolina and that I shall not violate the laws or any rules or standard of conduct published by the North Carolina Board of Architecture and Registered Interior Designers.

I have never had a credential or license/registration denied, limited, reprimanded, suspended, disciplined in any manner or revoked.

I have never been convicted of a felony or misdemeanor under any laws.

There are no criminal charges pending against me.

I have not been found guilty of misconduct, unprofessional conduct, dishonest or fraudulent practice, or incompetent practice by any court, board, agency, college, university or professional organization.

There are no charges pending against me before any court, board, agency, or professional organization for unprofessional conduct, dishonest or fraudulent practice or incompetent practice.

I certify that I have read and understand the Public Notice Statement required by NCGS § 143-764(a)(5). The Public Notice Statement is found at http://www.ic.nc.gov/121317ECSPublicNotice.pdf

I certify that I have not been investigated for employee misclassification per NCGS 143-764(a)(5). Questions regarding employee misclassification should be directed to NC Industrial Commission at 919-807-2582

If any answer to questions above is YES, you will need to submit a paper application with the full details and, if applicable, attach a copy of the final order.

I hereby depose and say that I am the person making the forgoing statements and that they are in good faith and are true in every respect.

Application for Registration as an Interior Designer Fee: $155

Registration Information

Instructions

Projects/Services

CERTIFICATION

AFFIDAVIT