Get Associates Application - American Speech-language-hearing ...

Filling out the Associates Application to become a member of the American Speech-Language-Hearing Association is a straightforward process. This guide will walk you through each step, ensuring you provide all necessary information accurately and efficiently.

Follow the steps to complete your application effectively.

1. Click the ‘Get Form’ button to acquire the Associates Application and open it in the designated editor.
2. Begin by filling out the personal information section. Enter your title, first name, middle name, last name, previous name (if applicable), mailing address, city, state or province, zip or postal code, phone or cell number, and email address. Indicate whether you are applying as a speech-language pathology associate or an audiology associate.
3. In the employment status section, select whether you are employed as a speech-language pathology assistant or an audiology assistant. If employed, make sure to complete Section 5a. If not employed, complete Section 5b.
4. Proceed to the licensure, registration, or certification status section. Check whether you are licensed, registered, or certified to work as a speech-language pathology assistant or as an audiology assistant, and provide the necessary information if applicable.
5. Next, address your qualifications. Indicate if your education or training meets state requirements for the relevant assistant roles. Specify the highest level of education you have completed and provide details of your degree or relevant training.
6. Obtain a verifying signature. If employed, you will need the signature from your supervising ASHA-certified professional. If not employed, get the signature from your program director or instructor.
7. Review and agree to the ASHA Associate responsibilities, ensuring you understand the scope of your role and the tasks you can perform.
8. Complete the payment information section, selecting your method of payment, and include necessary details such as credit card number or a check.
9. Finally, save any changes made to the application, download it for your records, and print or share the form if required.

Complete your Associates Application online today to join the American Speech-Language-Hearing Association.