1. An applicant for examination must file an application with the Secretary of the Board on a form to be furnished by the Executive Director of the Board. An applicant may take the examination any time after the Executive Director determines that his or her application is complete. 2. An application must be verified and must state: (a) When and where the applicant was born, the various places of the applicants residence during the 5 years immediately preceding the making of the application and the address to which he or she wishes the Board to mail the license. (b) The name, age and sex of the applicant. (c) The names and post office addresses of all persons by whom the applicant has been employed for a period of 5 years immediately preceding the making of the application. (d) Whether or not the applicant has ever applied for a license to practice chiropractic in any other state and, if so, when and where and the results of the application. (e) Whether or not the applicant has ever been admitted to the practice of chiropractic in any other state and, if so, whether any discharge, dismissal, disciplinary or other similar proceedings have ever been instituted against the applicant. Such an applicant must also attach a certificate from the chiropractic board of each state in which the applicant was licensed, certifying that the applicant is a member in good standing of the chiropractic profession in that state, and that no proceedings affecting the applicants standing as a chiropractic physician are undisposed of and pending. (f) The applicants general and chiropractic education, including the schools attended and the time of attendance at each school, and whether the applicant is a graduate of any school or schools. (g) The names of: (1) Two persons who have known the applicant for at least 3 years; and (2) A person who is a chiropractic physician licensed pursuant to the provisions of this chapter or a professor at a school of chiropractic. (h) All other information required to complete the application. 3. An application must include: (a) A copy of the applicants official transcript from the school or college of chiropractic or the doctor of chiropractic degree program from which the applicant received his or her degree of doctor of chiropractic, which must be transmitted by the school or college of chiropractic or the doctor of chiropractic degree program directly to the Board. (b) A statement from the applicant which attests, on a form prescribed by the Board, that the applicant has read, understood and will abide by the provisions of this chapter and chapter 629 of NRS and the regulations adopted pursuant thereto.
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