<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000001 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000003 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    </span><a href="https://sdlegislature.gov/Rules?Rule=20:61:01:03"><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000000">20:61:01:03</span></a><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000001">.  Required contents of applications</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000001"> for licensure</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000001">.</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">An application for an emergency medical services personnel license must contain</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">:</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002"> </span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    (1)  An affidavit, with a photograph of the applicant attached, attesting to the applicant's qualifications required by SDCL </span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=36-4B"><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000003">36-4B</span></a><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> and this chapter;</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002"> </span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    (</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">2</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">)  A list of all states in which the applicant is or has at any time been licensed to perform any type of </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">emergency medical services</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">;</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002"> </span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    (</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">3</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">)  A </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">list</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> of all places where the applicant has previously provided </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">emergency medical</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> services;</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002"> </span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    (</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">4</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">)  A </span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">signed </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">statement</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> listing</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> any criminal offense</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> for which the applicant has been convicted</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">; and</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002"> </span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    (</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">5</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">)  </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">The dates and locations</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> of all schooling relating to </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">emergency medical services</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">.</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002"> </span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000001">Source:</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> 5 SDR 68, effective February 15, 1979; 12 SDR 151, 12 SDR 155, effective July 1, 1986</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">; 51 SDR 56, effective November 19, 2024</span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">.</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000001">General Authority:</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=36-4B-35"><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000003">36-4B-35</span></a><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">.</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">    </span><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000001">Law Implemented:</span><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=36-4B-13"><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0-000003">36-4B-13</span></a><span class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34C0">.</span></p><p dir="ltr" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34P0"><span xml:space="preserve" class="sf6bcdbdd-0ab1-4cb2-9019-5bd492756d34000002"> </span></p></div></body></html>