An applicant for renewal of a license under this chapter shall

1. (1) complete a sworn renewal application on a form provided by the department;
2. (2) pay the license renewal fee established in 12 AAC 02.155; and

3. (3) submit a sworn statement of the continuing education contact hours completed during the concluding licensing period, which must include the following information, if applicable, for each course, seminar, or workshop:

   1. (A) the name of the sponsoring organization;
   2. (B) the location of the course, seminar, or workshop;
   3. (C) the title or a brief description of the course, seminar, or workshop;
   4. (D) the principal instructor;
   5. (E) the dates of attendance;
   6. (F) the titles, issues, and dates of publications or presentations; and
   7. (G) the number of continuing education contact hours claimed.

(Eff. 9/26/91, Register 119; am 10/14/99, Register 152; am 2/28/2009, Register 189)

Authority: AS 08.95.030, AS 08.95.040