Please print this document, fill out all required fields (marked by *) and return this form with your fees, payable in US funds, to:
Continuing Education Registry, American-Speech-Language Hearing Association,
P.O. Box 1160 #340, Rockville, MD 20849
*Name
__________________________________________________
First MI Maiden Last
*Mailing Address
__________________________________________________
__________________________________________________
*Phone _____________________
*E-mail _____________________
*ASHA/NSSLHA Membership Number or SSN/Canadian #
__________________________________________________
I am paying annual CE Registry fee(s) for calendar year(s):
________, ________, ________, _________ |
______ ASHA/NSSLHA member annual CE fee ($24)
______ Nonmember fee ($34) |
$_____ Total enclosed |
Please keep the following information for your records.
Year(s) Paid _______
Fee Paid $ ________
Check # _________ Documenting your continuing education is as easy as 1-2-3!
- Complete the ASHA CE Registry subscription form above and send it, along with your payment, to the ASHA CE Registry. You will be credited with an electronic voucher to request one free transcript. Vouchers are valid for 5 years from issue date.
- Look for this logo and participate in any ASHA CE Provider' s continuing education activity (conventions, workshops, self-studies, journal studies, etc.), participate in a Learn & Earn program, or develop an Independent Study through an ASHA Approved Independent Study Provider.
- Follow the instructions for earning ASHA CEUs as directed by the ASHA Approved CE Provider. After the CE Provider verifies your satisfactory completion of the course, ASHA CEUs will be awarded and recorded on your permanent ASHA CE Registry transcript.
|
If you have questions about your CE fee or the ASHA CE Registry,
please contact the CE Registry @ 1-800-498-2071; ext. 8591
or e-mail continuinged@asha.org.
|
|