The application form for a license, credential, or commission shall be issued by the Director of the Division of Arkansas State Police and shall include:

1. (1) The name, address, place and date of birth, and sex of the applicant;
2. (2) The driver's license number and Social Security number of the applicant;
3. (3) If the applicant was born outside of the United States, proof of eligibility to work in the United States, including, but not limited to, a United States passport, born abroad certificate, naturalization papers, permanent residency card, visa/Green Card, I-9 form, I-766 form or “work permit”, etc.;
4. (4) A statement as to which license or licenses, credential or credentials, or commission or commissions the applicant is seeking; and

5. (5) Questions related to the applicant’s qualifications specified in:

   1. (A) Arkansas Code § 17-39-202, § 17-39-206, § 17-39-304, § 17-40-306, or § 17-40-337; or
   2. (B) 17 CAR § 250-901, 17 CAR § 350-902, or 17 CAR § 350-1005(3).