N.H. Admin. Code § Ath 403.03

Current through Register No. 50, December 12, 2024

Section Ath 403.03 - Reinstatement Application Form

(a) The reinstatement application form shall:

(1) Be the "Reinstatement Application Form" specified in Ahp 601.02;

(2) Be provided by the board and available on the boards web site, https://www.oplc.nh.gov/applications-athletic-trainers; and

(3) Be signed and dated below the following preprinted statement which asserts:

"I acknowledge that knowingly making a false statement on this application form is a misdemeanor under RSA 641:2, I. I certify that the information I have provided on all parts of the application form and in the documents that I have personally submitted to support my application is complete and accurate to the best of my knowledge and belief. I also certify that I have read the statute and rules of the Board and promise that, if I am licensed, I will abide by them. Based on the statute and rules governing the profession for which I am applying I have not committed any acts that would be grounds for disciplinary action in this or any other State"

N.H. Admin. Code § Ath 403.03

#9099, eff 3-1-08; ss by #9855-A, eff 1-25-11; ss by #10498, eff 12-31-13

Derived From Volume XXXV Number 36, Filed September 10, 2015, Proposed by #10921, Effective 8/29/2015, Expires8/29/2025.

Amended by Volume XLII Number 2, Filed January 13, 2022, Proposed by #13307, Effective 12/17/2021, Expires 12/17/2031 (see Revision Note at chapter heading for Ath 400)