Brooks Employee Registration $40 Membership First Name:* First Name Required Last Name:* Last Name Required Address Line 1:* Address Line 1 is Required Address Line 2: Address Line 2 is not valid City:* City is Required State:* State is Required Zip Code:* Zip Code is Required Phone Number: Phone Number is not valid Florida License Number:* Florida License Number is Required ASHA Number:* ASHA Number is Required If you are a Bilingual SLP, the language(s) you provide services in: If you are a Bilingual SLP, the language(s) you provide services in is not valid English Spanish Arabic Filipino, Tagalog Vietnamese Haitian Portuguese Mandarin (Chinese) Cantonese (Chinese) French German Italian Albanian American Sign Language Khmer Area of expertise: Area of expertise is not valid Accent Modification Aphasia Apraxia Augmentative Alternative Communication Aural Rehabilitation Autism Bilingualism Brain Disorders (neurogenics) Central Auditory Processing Disorders Childhood Language Disorders Cleft Palate Cognitive Communication Disorders Communication Enhancement / Corporate Speech-Language Pathology Dementia Developmental Disorders Dysarthria Early Intervention Fluency Laryngectomy Learning Disabilities Literacy Oral Myofunctional Disorders Resonance Disorders Social Communication Disorders Swallowing Disorders Transgender Voice Traumatic Brain Injury Voice Disorders Telepractice / Telehealth Advocacy Clinical Education & Supervision Compliance Issues Ethics Grant Writing Informational Technology (apps / web) Leadership in the Profession (local, state, national) Multicultural Issues Publishing Research State Regulatory / Licensing Issues What do you hope to gain from joining JASPA most?:* What do you hope to gain from joining JASPA most? is Required Continuing Education Professional Networking Opportunities for Outreach and Charity SLP Social Events and Fun How did you find/hear about us?:* How did you find/hear about us? is Required Friend Employer Email Google Search Facebook Instagram Website Username:* Invalid Username Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Have a coupon? Coupon Code: Invalid Coupon Description Amount Brooks – Payment $40.00 Total $40.00 Stripe Payment Javascript is disabled in your browser. You will not be able to complete your purchase until you either enable JavaScript in your browser, or switch to a browser that supports it. No val Please fix the errors above
