Verification of Information Verification of Information for Invited Board CertificationAll Specialty Certification is awarded under the auspices of the ASHA guidelines. Every Board Certified Specialist must comply with the requirements as defined by the CFCC/CCSC. As approved by the CCFC/CSCC, the ABCLLD has established a process by which we may grant Board Certification in Child Language by securing evidence that every Board Certified Specialist meets the requirements; therefore, please complete the information below. (Should you have any difficulty submitting this form, please email ChildLanguageSpecialist@gmail.com.)Name and Credentials*Upload Curriculum Vita*Accepted file types: pdf, doc, docx, rtf, Max. file size: 10 MB.Upload Documentation of Endeavors*Accepted file types: pdf, doc, docx, rtf, Max. file size: 10 MB.ASHA # / Equivalent Certification #*Upload Copy of ASHA or Equivalent Certification Card*Accepted file types: jpg, png, jpeg, pdf, Max. file size: 10 MB.Work Email Address* Work Phone Number*Personal Email Address* Home / Cell Phone Number*I wish to accept your invitation to apply for Board Certification as a Child Language Specialist. I am uploading my CV, resume, or NIH/NSF Biosketch and a copy of my ASHA card or equivalent certification card. I understand that if approved for Invited BCS status, I will be required to pay the certification fee of $100 annually each fall for the subsequent year. I certify that I have met the requirements of 100 clock hours of intermediate or advanced continuing education related to child language and language disorders. These activities have occurred within the last 10 years.Applicant e-Signature*Today's Date* MM slash DD slash YYYY
