20:72:03:01.  Information required. The board shall determine qualification for licensure from information given on the application form; examination, if required; fees as required by § 20:72:03:04; and any additional information the board considers necessary for clarification of submitted material.

          Persons seeking audiology licensure must include with the application the following information:

          (1)  Type of annual license;

          (2)  Name, address, phone number, and date of birth of applicant;

          (3)  Name of employer, address, and phone number;

          (4)  Name of supervisor;

          (5)  Name and location of regionally accredited college or universities attended where master's degree or doctorate in audiology was issued;

          (6)  Proof of passing the national examination in audiology;

          (7)  Verification of completion of a supervised graduate professional experience in audiology supervised by a licensed or certified audiologist; and

          (8)  Employment record for the previous five years.

          Source: 24 SDR 33, effective September 22, 1997.

          General Authority:SDCL 36-24-46.

          Law Implemented:SDCL 36-24-17.1, 36-24-17.3.