(A) A veterinarian who meets all of the following requirements is eligible to apply for participation in the veterinarian student debt assistance program:

1. (1) The veterinarian is a citizen of the United States, a national of the United States, or a permanent resident of the United States.
2. (2) The veterinarian is licensed under this chapter and has been engaged in the practice or instruction of veterinary medicine in this state for more than six months prior to submitting an application for veterinarian student debt assistance.
3. (3) The veterinarian has taken out an educational loan.
4. (4) The educational loan was used for educational expenses that were incurred while the veterinarian was enrolled in a veterinary college.
5. (5) The veterinarian has performed charitable veterinarian services in accordance with rules adopted under section 4741.51 of the Revised Code.
6. (6) The veterinarian is not a member of the state veterinary medical licensing board at the time the application is submitted under division (B) of this section.
7. (7) The veterinarian is not under contract with the board under section 4741.54 of the Revised Code and has not been under contract with the board under that section within one year prior to submitting an application.

(B) A veterinarian shall submit an application for participation in the veterinarian student debt assistance program to the state veterinary medical licensing board on a form that the board prescribes. The veterinarian shall submit the following information with an application:

1. (1) The veterinarian's name, permanent address or address at which the veterinarian is currently residing if different from the permanent address, and telephone number;
2. (2) The veterinary college the veterinarian attended and the dates of attendance;
3. (3) A summary and verification of the educational expenses for which the veterinarian seeks reimbursement under the program;
4. (4) Verification of the veterinarian's authorization under this chapter to practice veterinary medicine;
5. (5) Verification that the veterinarian is a citizen of the United States, a national of the United States, or a permanent resident of the United States;
6. (6) A statement attesting that the veterinarian performed charitable veterinarian services in accordance with rules adopted under section 4741.51 of the Revised Code;
7. (7) Any other information the board determines is necessary and appropriate.