SLP-A Course Sequence Application

Thank you for your interest in the SLP-Assistant Program. To be considered for admission to the course sequence, please complete the following application.

IMPORTANT: Your application will not be considered complete until you mail the following supporting documents: your resume, all post secondary transcripts, at least 2 letters of recommendations and a letter of intent that describes your other areas of training, your employment history in schools, reasons for applying to the SLP-Assistants program and your plans following completion of the program. Please mail these to: Maria Short, Communication Sciences Department, 410 Pomeroy Hall, University of Vermont, Burlington, VT 05405. Materials may also be sent as attachments to maria.short@uvm.edu or via fax (802) 656-2528 Attention: Maria Short.

If you have any questions regarding this program, please contact the Project Coordinator, Maria Short, at Maria.Short@uvm.edu, or (802) 656-5745.

Name:

First Name
Last Name

Mailing Address:

Address1
Address2
City
State/Province
Postal Code

Other Contact Information:

Home Phone
Work Phone
Email Address

Educational Background:

High School diploma
Some College, no degree
Associate’s Degree, Major:
Bachelor’s Degree, Major:

Current Employment:

Company/School
Position
Number of Years Employed

Do you have access to a school-based Speech-Language Pathologist who is certified by ASHA for supervision during this SLP-Assistant Program?

Yes
No
Not Sure

Are you committed to completing the entire course sequence within one year of your acceptance?

Yes
No
Not Sure

Are you committed to service as a Speech-Language Pathology Assistant in the schools?

Yes
No
Not Sure