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APPLICATION FOR OCCUPATIONAL THERAPYCompletion of this application form is necessary for consideration for licensure. Disclosure of this information is voluntary; however, failure to disclose all

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Fill out personal information on Form DS-11, including full name, date of birth, and address.

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Department of State is a government agency responsible for handling foreign affairs and international diplomatic relations.

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The purpose of department of state is to regulate business entities, maintain accurate records, and ensure compliance with state laws and regulations.

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Information such as business name, address, registered agent, business activities, and ownership details may need to be reported on department of state.

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