11 NCAC 08 .0704             APPLICATION FORM: CONTENTS

The application form requires the applicant to furnish all of the following pertinent information necessary to determine the qualifications of the applicant for a standard certificate:

(1)           the date;

(2)           name, address, and telephone number where applicant can be reached;

(3)           date of birth;

(4)           education;

(5)           work experience;

(6)           certificates and other professional licenses, if any, held previously or currently;

(7)           type and level of certificate for which application is made;

(8)           governmental unit by which currently employed;

(9)           supporting data needed for verification of applicant's qualifications called for by Rule .0706 or .0707 of this Section; and

(10)         Social Security number.

History Note:        Authority G.S. 143‑151.13;

Eff. January 15, 1980;

Amended Eff. July 18, 2002;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018.