
NORTH DAKOTA STATE BOARD OF EXAMINERS ON AUDIOLOGY AND SPEECHLANGUAGE PATHOLOGY LICENSE RENEWAL APPLICATION Please send before December 1, 2020 (If received after December 1, we cannot guarantee issuance.
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How to fill out the ND NDSBE License Renewal Application online
The ND NDSBE License Renewal Application is essential for audiologists and speech-language pathologists looking to renew their licenses in North Dakota. This guide provides detailed, step-by-step instructions to assist you in completing the application accurately and efficiently online.
Follow the steps to complete your license renewal application online.
- Press the ‘Get Form’ button to access the ND NDSBE License Renewal Application form and open it in your preferred editing tool.
- Fill in your license number in the designated field.
- Select the appropriate license type by checking the relevant box: Audiologist (AUD), Speech-Language Pathologist (SLP), or Speech-Language Pathology Assistant (SLPLA).
- Indicate the renewal year, which should be 2021.
- Enter your full name, including any previous last names if applicable.
- Provide your complete address, including city, state, and ZIP code. Indicate if your address has changed since January 1, 2019 by checking 'Yes' or 'No'.
- List your home and business phone numbers in the specified format.
- Make sure to include your email address.
- Document your present employment by including the name, address, and ZIP code of your employer.
- In the continuing education experience section, list details for each seminar attended, including the date, place, title, presenter, and number of hours. Attach proof of attendance if required.
- Sign the affidavit, certifying that the information you provided is accurate and that you agree to abide by the ethical standards set by the board.
- Record the date of your signature.
- Ensure that your application is complete, including the signed form, proof of continuing education, and payment of the $75.00 fee.
- After confirming all information is correct, save your changes, and prepare to print or share your completed application.
Complete your ND NDSBE License Renewal Application online today to ensure timely processing!
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