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Product Submission Form

Please answer the questions that are most relevant to your submission. If a question is not applicable to your publication or product, please leave the answer space blank or simply write in "N/A".

If you do not agree with the stated Submission Policy and Agreement, do not complete the Submission Form or submit any documents, materials, designs, products, ideas, proposals, suggestions, and the like to ASHA.

* indicates required field.


Yes, my submission is made in accordance with ASHA's Submission Policy and Agreement.*

Publisher or Author's/Developer's First Name:*

Publisher or Author's/Developer's Last Name:*

Mailing Address:*



Zip Code:*

Home Phone Number:

Office Phone Number:*



Please check the stage of development for your submission.*

*If other, please specify.

Book Title or Product Name:*

Manuscript or Product Completion Date (mark complete if published):*

Length of Book (word count or double-spaced typescript pages):*

Have you offered the project to any other publisher?*

*If "Yes," where and what stage of agreement has been reached?

Has any of the material previously been published?*

*If "Yes," where has it been published?

Biography Describing Your Professional Credentials (50 word max):*

Describe the book's contents, format, approach and style (include a table of contents).*
If the book proposed is an edited, multi-contributor volume, the table of contents should be annotated with brief paragraphs describing the content of each chapter, accompanied by a list of proposed contributors, if applicable.

Is there research to support any claims about the product?*

*If "Yes," please list any research or references to support these claims. You may be asked to send more detail separately at a later time.

Why would this be of interest to SLPs, audiologists, speech and hearing researchers, or anyone interested in communication disorders?*

What is the scientific, educational, or clinical significance of this book or product?*

How does this book or product differ from other books or products on the same subject?

Please describe your publishing or other experience that you wish ASHA to consider.

Suggested Retail Price:

Current Sales (if already in distribution):

Percent Revenue from SLPs and/or Audiologists and Any Other Markets:

Please list up to two professional references who could comment on the quality of your research, publication(s), and/or product line.

Reference 1 First Name:*

Reference 1 Last Name:*


Phone Number:


Reference 2 First Name:*

Reference 2 Last Name:*


Phone Number:



ASHA Corporate Partners