20:61:01:03.  Required contents of applications for licensure. An application for an emergency medical services personnel license must contain:

    (1)  An affidavit, with a photograph of the applicant attached, attesting to the applicant's qualifications required by SDCL chapter 36-4B and this chapter;

    (2)  A list of all states in which the applicant is or has at any time been licensed to perform any type of emergency medical services;

    (3)  A list of all places where the applicant has previously provided emergency medical services;

    (4)  A signed statement listing any criminal offense for which the applicant has been convicted; and

    (5)  The dates and locations of all schooling relating to emergency medical services.

    Source: 5 SDR 68, effective February 15, 1979; 12 SDR 151, 12 SDR 155, effective July 1, 1986; 51 SDR 56, effective November 19, 2024.

    General Authority: SDCL 36-4B-35.

    Law Implemented: SDCL 36-4B-13.