Five Year Renewal Form

Board Certification as a Child Language Specialist must be renewed every five years. To maintain Board Certification, complete and submit this form verifying that you have met the requirements specified in the Manual of Policies & Procedures.

Address of Employer(Required)
I am maintaining documentation of my completion of 100 hours of intermediate- or advanced-level continuing education in child language within the past five years should I be audited. (initial required below)
Home Address(Required)
(for records purposes only)
Check the activities related to child language in which you participate.(Required)

By payment of your annual fee and submission of this completed Five-Year Renewal Form, you affirm that you have met all requirements for Board Certification in Child Language renewal and verify that your Certificate of Clinical Competence is active.

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