New Hampshire Code of Administrative Rules
Rec - Advisory Board of Recreational Therapists
Chapter Rec 400 - CONTINUED STATUS
Part Rec 403 - REINSTATEMENT OF LICENSES
Section Rec 403.05 - Reinstatement Application Form
Current through Register No. 12, March 21, 2024
(a) The reinstatement application form shall be the "Application for Reinstatement of Licensure and Certification" dated September 3, 2015. The reinstatement application form shall be provided by the board and available by submitting a request for the application form on the board's website, www.nh.gov/alliedhealth.
(b) To apply for reinstatement, the applicant shall:
"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 the rules of the Board and promise that, if I am licensed, I will abide by them."
(c) The effect of the reinstatement applicant's notarized signature on the application form shall be:
#9447, eff 4-7-09