Apply Now - American Board of Child Language and Language Disorders

Application Form for Board Certification
as a Specialist Child Language

Have you read the Overview of the Application Process PDF and determined you are ready to apply? If so, to begin the application process for Board Certification in Child Language, complete this form and submit your payment of $250. This payment is nonrefundable.

First Name(Required)

Last Name(Required)

Credentials(Required)

Home Address(Required)
Street Address City State / Province / Region ZIP / Postal Code Country

Primary Phone Number(Required)

Secondary Phone Number

Work Email Address

Personal Email Address(Required)

ASHA #(Required)

How did you hear about Board Certification in Child Language?(Required)

Application Fee(Required)

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Application Form for Board Certificationas a Specialist Child Language

Application Form for Board Certification
as a Specialist Child Language