Transcription of License Application Package for Required Professional ...
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Application Checklist for Speech-Language Pathologists Required Professional Experience ( Graduates) Visit our Frequently Asked Questions page (link available under the Applicant/Registrant tab) for more information. If you need additional assistance, please email the Board at Items 1-4 are Required for the issuance of the RPE temporary License . 1. Application Remember to attach a 2x2 passport-quality photograph and provide original signatures. Please answer all questions. 2. Fees $35 check or money order to the Board, made payable to SLPAHADB.
must be completed by applicant and . Part B . must be completed with supervisor. Please submit a complete application. Do not use whiteout. Any corrections - to this form must be crossed out and initialed. The completed application form must be . mailed . to the Board. Application is formatted to be typed. May also be handwritten legibly.
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