Board Member Application | Louisiana Board of Examiners for Speech-Language Pathology and Audiology

CALL FOR NOMINATIONS

I meet the following requirements:

I am a resident of the State of Louisiana.

I hold a valid license in the area of service (Audiology or Speech-Language Pathology).

I have been engaged in providing service, or in teaching, or in research in audiology or speech-language pathology for at least five years.

I meet all the qualifications as specified in R.S.37:2654.I.

I will mail my notarized statement listing and verifying professional experience. Notarized statement must affirm that the information provided is true and correct and must be received by the date listed on the Board Nominations Page.

Please describe your interest in service on the licensure board and your qualifications for services (e.g. professional experience, services to professional organizations, awards, etc.). This description will be provided to the Governor as written, in addition to your name, title/affiliation, and degree information. The maximum length is 175 words. Content will be edited if maximum length is exceeded.

By typing your name above, you are signing this nomination electronically. You agree that your electronic signature is a legal equivalent of your manual agreement on this nomination.