An individual who does not wish to renew his or her certification as a speech-language assistant shall so indicate by:

1. (a) Submitting only the first page of the board-provided renewal form on or before December first of the renewal year; and

2. (b) Completing that page only to the following extent:

   1. (1) Adding to or correcting as necessary the following to the preprinted home mailing address:

   2. (2) Placing on the lines provided for a person not wishing to renew:

      1. a. His or her signature; and
      2. b. The date of signing.

Source. #9711, eff 5-8-10; ss by #10684, eff 10-4-14