Application by a duly licensed chiropractor of the State of New York to practice under the Workers' Compensation Law shall be made upon a form furnished by the chairman, Workers' Compensation Board, which shall be filed with the Chiropractic Practice Committee, Workers' Compensation Board, 180 Livingston Street, Brooklyn, NY 11248. Such application shall state, fully and truthfully, all the information required by law and the applicant shall make and sign the statutory agreement. The chairman will notify the chiropractor of approval of his or her application within 60 days after receipt by the chairman of a recommendation for approval from the Chiropractic Practice Committee.