An applicant for licensure as a physical therapist or physical therapist assistant shall file an application with the board on forms prescribed and furnished by the board. The application shall be made under oath, and shall show the applicant's address, education, evidence of graduation from a nationally accredited school of physical therapy or nationally accredited school for physical therapist assistants with a curriculum acceptable to the board and a detailed summary of any other qualifications deemed relevant to licensure by the board. The application shall also require the disclosure of any criminal conviction or charge against the applicant other than minor traffic infractions, the disclosure of any disciplinary action against the applicant by any professional regulatory agency, including any agency within the state or any other state, and the disclosure of any denial of registration or licensure by any state or district regulatory body. A nonrefundable application fee and payment for the cost of the examination shall accompany the completed written application. Fees shall be established by the administrative rules of the board.
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