Section Plc 704.01 - Initial License Application Submission(a) Any individual who wishes to engage in the practice of electrolysis in New Hampshire who does not hold a current New Hampshire electrology license shall file an application for an electrologist license in accordance with this section.(b) An applicant for licensure as an electrologist shall complete and submit an "Application for State of New Hampshire License to Practice Electrology" form, dated September 2022, that includes the following:(1) Whether the application is for an initial license or a license by reciprocity;(2) Information identifying the applicant, as follows: a. First name, middle name, and last name;b. Month, day, and year of birth;c. Social security number as required by RSA 161-B:11, VI-a and 42 U.S.C. 666(a)(13);e. Home or other personal telephone number including area code; andf. Personal email address;(3) The name and address of the electrology school attended, dates attended, and the total number of hours of instruction received;(4) If known, the approximate date the applicant wishes to begin practice in New Hampshire;(5) The name of each jurisdiction where the applicant holds or held a license, certificate, registration, or any other form of approval required to practice electrolysis and, for each, the following:b. The number of years the applicant was licensed; andc. The status of the license or certificate, including whether a license was denied or is active, suspended, or revoked;(6) The name, physical address, and telephone number including area code of the office where the applicant intends to work and, if available, the URL of the office's website and the office's email address;(7) Transcripts from the electrology school from which the applicant graduated to verify that the applicant has completed 1,100 hours of education as required by Plc 704.03(b)(2);(8) At least 2 affidavits of professional character from professional associates in the format provided with the application, provided that if the applicant graduated less than one year prior to the time of application, affidavits from faculty members of the electrology school may be submitted;(9) If the applicant previously held a license in New Hampshire that was revoked, the plan of correction required by Plc 706.02(d); and(10) The applicant's dated signature under the following pre-printed statement: "By my signature, I attest full compliance with RSA 314 and all corresponding New Hampshire rules and that the information and documentation provided are true, complete, and not misleading to the best of my knowledge and belief. I understand that knowingly providing information that is false or misleading may be grounds for denial, suspension, or revocation of a license."
(c) The applicant shall submit the completed application to the executive director with the application processing fee specified in Plc 1002.(d) If the application is denied in accordance with Plc 704.03, the application processing fee shall not be refunded to the applicant.N.H. Admin. Code § Plc 704.01
Derived from Volume XLII Number 49, Filed December 8, 2022, Proposed by #13495, Effective 12/22/2022, Expires 12/22/2032 (see Revision Note at chapter heading for Plc 700).