Application for assessment of internationally educated audiologists and speech-language pathologists First Name: Last Name: Gender: ☐ Female ☐ Male Applying for membership as an/a: ☐ Audiologist ☐ Speech-Language Pathologist Preferred contact information: E-mail address: Telephone number: Are you a member of another Canadian professional association, college or licensing body in speech- language pathology or audiology? ☐ Yes ☐ No If yes, which one? If no, are you applying concurrently to another Canadian professional association, college or licensing body in speech-language pathology or audiology? ☐ Yes ☐ No If yes, which one? Have you submitted your credentials to be evaluated by the International Qualifications Assessment Service (IQAS)? ☐ Yes ☐ No Speech-Language & Audiology Canada Application Checklist: ☐ $500 Assessment fee (payable to SAC by Visa, MasterCard, certified cheque or money order) ☐ Official degree transcripts ☐ Complete course descriptions including hours of study ☐ Verified signed record of clinical practicum hours ☐ Official translation of documents if not in English ☐ IQAS or WES assessment report The application fee is being paid by: ☐ VISA ☐ MC ☐ Certified Cheque ☐ Money Order Credit Card Number: Expiry Date: Credit Card Security Code: Signature: Mail all documents and fee to: SAC, 1000-1 Nicholas St., Ottawa, ON K1N 7B7 Canada * All documents and fees must be received before the assessment can begin. The assessment will take approximately 8 - 12 weeks.
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Application for assessment of internationally educated audiologists and speech-language pathologists
First Name:
Last Name:
Gender: ☐ Female ☐ Male
Applying for membership as an/a: ☐ Audiologist ☐ Speech-Language Pathologist
Preferred contact information:
E-mail address:
Telephone number:
Are you a member of another Canadian professional association, college or licensing body in speech-language pathology or audiology?
☐ Yes ☐ No If yes, which one?
If no, are you applying concurrently to another Canadian professional association, college or licensing body in speech-language pathology or audiology?
☐ Yes ☐ No If yes, which one?
Have you submitted your credentials to be evaluated by the International Qualifications Assessment
Service (IQAS)? ☐ Yes ☐ No
Speech-Language & Audiology Canada Application Checklist:
☐ $500 Assessment fee (payable to SAC by Visa, MasterCard, certified cheque or money order)
☐ Official degree transcripts
☐ Complete course descriptions including hours of study
☐ Verified signed record of clinical practicum hours
☐ Official translation of documents if not in English
☐ IQAS or WES assessment report
The application fee is being paid by: ☐ VISA ☐ MC ☐ Certified Cheque ☐ Money Order
Credit Card Number: Expiry Date:
Credit Card Security Code: Signature:
Mail all documents and fee to: SAC, 1000-1 Nicholas St., Ottawa, ON K1N 7B7 Canada * All documents and fees must be received before the assessment can begin. The assessment will take
approximately 8 - 12 weeks.
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