Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your license number in the designated field. This is crucial for identifying your records correctly.
3. Select your license type by checking one of the boxes: Audiologist (AUD), Speech-Language Pathologist (SLP), or Speech-Language Pathology Assistant (SLPLA).
4. Indicate the renewal year by selecting '2019' from the options provided.
5. Fill in your name, including any previous last names if applicable.
6. Provide your current address, including city, state, and ZIP code. If you have a new address since January 1, 2018, check the 'Y' box, otherwise check 'N'.
7. Include your home and business phone numbers, ensuring that they are accurate for communication purposes.
8. State your email address to facilitate electronic communication regarding your application.
9. Describe your present employment, including the address and ZIP code to provide evidence of your professional activity.
10. Complete the Continuing Education Experience section by attaching proof of attendance for relevant seminars. Include details such as dates, places, titles, presenters, and the number of hours attended.
11. Sign the affidavit confirming the truthfulness of your application and your adherence to the ethical standards set by the Board.
12. Review the completed application to ensure all sections are filled out correctly and double-check your enclosed payment of $75.00.
13. Save changes to your document, download or print a copy for your records, and share it as needed for submission.

Submit your ND NDSBE License Renewal Application online to ensure timely processing and approval.