Follow the steps to complete your application checklist online.

1. Press the ‘Get Form’ button to obtain the form and open it in your online editing tool.
2. Fill in your full legal name in the designated fields marked for last, first, and middle names.
3. Provide any other names you have used, including maiden names, in the space provided.
4. Enter your street address, city, state, and zip code correctly in the respective fields.
5. Input both your residence and business telephone numbers as required.
6. Submit your social security number (SSN) or individual tax identification number (ITIN).
7. Complete the date of birth field using the format MM/DD/YYYY.
8. Provide your email address for correspondence regarding your application.
9. Select the basis for filing from the options provided: A.A/A.S. degree, bachelor’s degree, or bachelor’s degree equivalency.
10. Indicate whether you or your partner is an active duty military personnel, which may impact your application processing.
11. Respond to the questions regarding prior licenses and disciplinary actions, ensuring to disclose any necessary details.
12. List all satisfactorily completed undergraduate education with the institution name, city/state, major field of study, degree received, and date degree received.
13. If applicable, indicate if you have completed a speech-language pathology assistant program and provide relevant verification.
14. Attach and submit the required documents, including transcripts, verification forms, and photographs, as specified in the form instructions.
15. Ensure you have properly signed and dated the application, certifying that all information is accurate.
16. Submit the application along with a check or money order for the required fee to the Board.
17. Finally, save any changes made to the form, and prepare to download, print, or share your completed application as needed.

Take the next step in your professional journey by completing your application online today.