Arizona Administrative Code
Title 4 - PROFESSIONS AND OCCUPATIONS
Chapter 49 - BOARD OF ATHLETIC TRAINING
Article 2 - LICENSURE
Section R4-49-203 - Renewal of License

1. Applicant's full name;

2. Applicant's name as it will appear on the renewal license;

3. Residence address and telephone number;

4. Current Arizona Board of Athletic Training license number;

5. Arrest, criminal conviction, and disciplinary actions from any licensing agency or court since last license renewal;

6. Social Security number;

7. Employer's name, address, and telephone number;

8. Attestation of compliance with the continuing education requirements listed in R4-49-208;

9. Attestation that applicant agrees to practice under the direction of a licensed physician as required by R4-49-405, including maintaining physician-approved written protocols for common athletic training activities and post-injury guidelines that comply with A.R.S. § 32-4103(B);

10. A readable fingerprint card and associated fee for submission to the Department of Public Safety or a current fingerprint clearance card issued by the Department of Public Safety if the previous submission is at least five years old or the Department of Public Safety clearance card will expire within the term of the renewed license;

11. Statement of lawful presence in the United States or submittal of required documents showing lawful presence;

.12. Signature and date with an attestation regarding the truthfulness of the information provided.