Section Gal 401.09 - Required Supporting Materials for Renewal CertificationIn addition to the completed renewal application form, a person shall also submit or cause to be submitted to the board:
(a) A fully executed state of New Hampshire criminal records release authorization form from the department of safety allowing for the disclosure of the applicant's current criminal record to the board dated within 6 months of the application;(b) A check made out to "State of NH - Criminal Records" in the amount specified by Saf-C 5703.10;(c) An original writing together with 3 copies from the central registry of founded abuse and neglect reports established under RSA 169-C:35 indicating that the applicant's name does not now appear in the central registry of founded abuse and neglect reports dated within 6 months of the application;(d) If the applicant's answer to Gal 401.07(d) (1) is yes and the information previously provided by the applicant on his or her most recent application form under the heading of "Professional Record and Ethics" in Gal 302.02(f) has changed in a manner that involves the issuance of an order, decision or other writing from a professional organization or supervising entity which sets forth the terms of a disbarment, revocation, suspension, reprimand, discipline, sanction, censure, disqualification, denial, fine, suspension, or penalty: (1) 4 copies of the order, decision, or other writing if any from the entity imposing the fine, suspension, sanction, penalty, denial, disqualification, censure, discipline, reprimand, disbarment, or revocation, setting forth the factual findings and conclusions; and(2) If the disbarment, revocation, suspension, reprimand, discipline, sanction, censure, disqualification, denial, penalty, or fine has ended, or if it was subsequently reversed or overturned on appeal, 4 copies of the order, decision or writing, if any, so relating to that matter;(e) If requested under Gal 401.03 or Gal 404.01, such additional information required by the board;(f) If the applicant is, at the time of his or her application, seeking approval of an activity not listed in Gal 403.03 for continuing education credit, a request for approval together with 3 copies as described in Gal 403.06; and(g) If the applicant is, at the time of the filing of an application, requesting an alteration of time in which to complete continuing education, an original signed, written request together with 3 copies pursuant to Gal 403.01(i).N.H. Admin. Code § Gal 401.09
Amended by Volume XXXVI Number 45, Filed November 10, 2016, Proposed by #12010, Effective 10/21/2016, Expires 11/1/2026.