The applicant for reinstatement shall complete and submit an “Application for Reinstatement” form, effective September 2018, along with the following additional documentation:

1. (a) Proof of 40 CEU clock hours earned in programs approved pursuant to Nur 402.03;
2. (b) A current passport sized photograph; and

3. (c) The applicant’s dated signature below the following attestation:

   “I certify that there are no willful misrepresentations in and falsifications of the above statements and answers to questions. I understand that inquiry may be made of my employers and of all references given about my character, qualifications, and record of employment, and if such an investigation should disclose misrepresentations and falsifications, my application will be rejected, and should I be licensed as a result of such statements, my license may be revoked.”

Source. #5326, eff 2-13-92, EXPIRED: 2-13-98 New. #7663, eff 3-19-02, EXPIRED: 3-19-10 New. #9830-B, eff 12-10-10; ss by #12690, eff 12-19-18