1. (a) Information from references shall be requested by the board on forms provided by the board as follows:

   1. (1) Applicant’s name;
   2. (2) Reference’s full name and address, relationship to the applicant, and status as a licensed professional geologist as defined in RSA 310-A:118, IV;
   3. (3) The reference’s business or profession;
   4. (4) Whether the reference is a licensed geologist and if so in what state and license number;
   5. (5) Whether the reference qualifies for licensure as a professional geologist in accordance with RSA 310-A:125, I;
   6. (6) How long the reference has known the applicant;
   7. (7) Whether the reference is related to the applicant;
   8. (8) The reference’s business connection with the applicant;
   9. (9) Whether the reference knows anything that reflects adversely on the integrity or good general character of the applicant;
   10. (10) A brief estimate of the applicant as a geologist;
   11. (11) Whether the reference would employ the applicant in a position of trust;
   12. (12) Whether the applicant is connected with a firm, the name and address of the firm, and the position that the applicant fills;
   13. (13) Whether the applicant is in individual practice and the nature of such practice;
   14. (14) Whether the reference recommends the applicant for licensure as a professional geologist; and
   15. (15) Remarks concerning the applicant.

2. (b) The reference shall sign and date the form below the following attestation:

   “I make the above statements with full knowledge that the person referred to is making application for licensure to the State of New Hampshire as a professional geologist.”

Source. #7526, eff 7-1-01; ss by #9439, eff 3-25-09; ss by #12152, eff 3-24-17