2012 CSI Registration

Courses

Individuals who intend to apply to sit for the certification examination in Auditory-Verbal Therapy should apply to attend both sections, as a combination of coursework and mastery of the Auditory-Verbal Teaching Behaviors is necessary to become a Listening and Spoken Language Specialist Certified Auditory-Verbal Therapist. I'd like to register for the following workshops:

Module Only: NC Resident (Free)

Module Only: Out-of-State ($300)

Module & Practicum: NC Resident ($700)

Module & Practicum: Out-of-State Resident ($1000)

First Name (Required)

Last Name (Required)

Your E-Mail Address (Required)

Phone Number (Required)

Fax Number

Address (Required)

State (Required)

City (Required)

Zip (Required)

Employer

Title

Certification

Are you interested in practicum hours for LSLS Cert Auditory-Verbal Education?

Yes

Housing

Are you interested in housing with a local CASTLE family for this event?

Yes

Scholarships

Limited scholarship money has been made available courtesy of special funding. To submit a request for scholarship, please write a statement here to support your need for scholarship funds to be able to participate in this year’s Carolina Summer Institute in Auditory-Verbal Therapy.

Yes, I am applying for scholarship.

Statement of Support

Please write a statement supporting your need for scholarship monies.

Statement of Intent (Required)

Please write 250-500 words on why you want to attend Summer Institute.

I have read and understand the registration guidelines (Required)

• Preference will be given to residents of North Carolina; however, professionals from out-of-state are encouraged to apply • The deadline for application to the Institute is Friday, March 30, 2012. Participants are encouraged to apply as early as possible to be considered • The total enrollment will be limited to 20 participants • Applicants will be notified of their acceptance into the Institute by Monday April 9, 2012 • Applications are not considered complete until payment has been received • Institute participants are responsible for their own food, parking, and lodging • Limited scholarships are available • This program is offered for 1.9 CEUs for the Module Portion (Intermediate Level, Professional Area) and 4.4 CEUs for the Practicum Portion (Intermediate Level, Professional Area) • Cancellation of attendance less than 3 working days prior to the workshop will result in the participant being charged for that accommodation.

Payment

Payment has been sent

Payment will be sent by a third party

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