New Hampshire Code of Administrative Rules
Geo - Board of Professional Geologists
Chapter Geo 300 - LICENSURE REQUIREMENTS
Part Geo 301 - APPLICATION REQUIREMENTS
Section Geo 301.02 - Application for Licensure
Universal Citation: NH Admin Rules Geo 301.02
Current through Register No. 12, March 21, 2024
(a) Each applicant for licensure shall provide, or cause to be provided, the following on an application for licensure form supplied by the board:
(1) The applicant's name, including
any names previously used;
(2) The applicant's residence
address, business name and address, email address, and telephone
numbers;
(3) The
applicant's date of birth, place of birth, and citizenship;
(4) For each of the applicant's
employers, the dates the applicant was employed, the name of the
employer, the title of the applicant's position, the location and
character of each position held by the applicant while working for
each employer, the degree of responsibility at each position, and the
name and present address of a licensed geologist familiar with each
position;
(5) The
applicant's educational history including:
a.The names and locations of all
high school and post-secondary institutions attended;
b.The dates of attendance,
major(s), and degrees awarded; and
c.Certified copies of transcripts
from all post-secondary institutions attended;
(6) A listing of every state in
which the applicant holds or has ever held registration/licensure as
a professional geologist including;
a.The license number;
b.The state of licensure;
c.The year licensed;
d.Number of hours of written
exam;
e.Whether
reciprocity or grandfather; and
f.Whether the license is active or
lapsed and if lapsed why;
(7) State in which the applicant
was first registered or licensed as a professional geologist, date of
licensure, the license number, and whether the license is now in
force and, if not, an explanation as to why;
(8) Whether the applicant has ever
applied for professional geologist licensure in New Hampshire and the
status;
(9) Whether the
applicant has ever lost or been denied registration or licensure as a
professional geologist or disciplined by another licensing board in
any other state and if so, an explanation of the
circumstances;
(10)
Whether the applicant has ever taken the National Association of
State Boards of Geology (ASBOG) Fundamentals of Geology examination,
and if so, the location, date, and grade awarded;
(11) Whether the applicant has ever
taken the National Association of State Boards of Geology (ASBOG)
Practice of Geology examination, and if so, the location, date, and
grade awarded;
(12)
Whether the registration or licensure as a professional geologist was
issued by examination and if so, the location, date and grade
awarded;
(13) A statement
indicating that the applicant has adhered to and agrees to abide by
the ethical and professional standards of the profession;
(14) Whether the applicant has ever
been convicted of any felony or any misdemeanor, or a violation
involving geology or the practice of professional geology and if so,
the name of the court, the details of the offense, the date of
conviction, and the sentence imposed;
(15) The names, complete addresses,
occupation and business relationship with applicant of 5 references
as specified in
Geo 302.03;
(16) A list of current memberships
in professional or scientific societies, including:
a.Name of organization;
b.Location;
c.Level of membership;
and
d.Dates of
memberships.
(17) The applicant's social
security number required pursuant to
RSA
161-B:11,
VI-a;
(18) Whether the applicant is
applying for facilitated licensure as a military spouse;
(19) Any additional experience
information the applicant wishes to provide;
(20) An affidavit acknowledging
that the applicant has provided correct and true information;
and
(21) The applicant's
signature and date under penalty of unsworn falsification, pursuant
to RSA
641:3, II.
(b) Each applicant for licensure who is a graduate of a non-United States or Canadian institution shall have his or her transcripts sent directly from the institution to World Education Services or a similar translation and authentication service which specializes in evaluating educational credentials for translation and authentication. The applicant shall request translation and authentication be sent from the translation and authentication organization directly to the board office for evaluation by the board.
(c) Applicants shall pay the application fee specified in Geo 305.02.
#7526, eff 7-1-01; ss by #9439, eff 3-25-09
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