(a) Application for approval shall be made on forms provided by the department. Information required from the applicant shall include:

1. (1) a description of services provided to victims of sexual offenses, sexual abuse or incest;
2. (2) a description of the program's community prevention education, training of professionals and outreach services;
3. (3) the program's curriculum for training rape crisis counselors, or confirmation of intent to use a curriculum approved by the department;
4. (4) a description of the program's training program, referred to in section 69-5.3 of this Subpart; and
5. (5) a description of the program's procedures to evaluate and monitor program services, including the performance of rape crisis counselors.