On a form provided by the commission, an applicant for an occupational license as a harness starting gate driver shall, in addition to the application form specified in Pari 605.05, supply the following:
(a) The name of the applicant as it appears on the form specified in Pari 605.05;(b) Whether or not the applicant is a member of the USTA, and if so, the applicant's membership number and expiration date;(c) Whether or not the applicant is licensed by the USTA for the calendar year being applied for;(d) A list of all USTA licenses and years held by the applicant for the most recent 3 years of licensure;(e) The name, address and telephone number of the person, corporation or association licensed under RSA 284:15 recommending the applicant for the occupational license;(f) The name, address and telephone number of the occupationally licensed starting gate driver who has agreed to supervise the applicant;(g) Whether or not the applicant has a valid New Hampshire driver's license, and if so, the license number and expiration date;(h) The applicant's signature on the statement set forth in Pari 605.28; and(i) The date of the signature described in (h) above.N.H. Admin. Code § Pari 605.16