Member Application

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IMPORTANT DATES

TO RECEIVE FALL CONFERENCE RATE…Applications MUST be received by August 31, 2012
TO RECEIVE SPRING CONVENTION RATE…Applications MUST be received by March 15, 2013

MEMBERSHIP FEES: 2012-2013

Prior to December 31, 2012		On or after January 1, 2013
Member	$ 90	Member	$115
Associate	$ 90	Associate	$115
Student	FREE	Student	FREE
Life	$ 25	Life	$ 40

Select membership level

* Mandatory fields

* Membership level

Associate - $115.00 (USD) Subscription period: 1 year, on: August 1st No recurring payments Hold Bachelor’s degree with a major emphasis in Speech-Language
Pathology, Audiology, Speech or Hearing Science, or Education of the
Hearing Impaired; must be employed in or a resident of Indiana. Any
person having held previous Active membership who no longer lives or
is employed in Indiana may transfer to Associate Membership.

Life member - $40.00 (USD) Subscription period: 1 year, on: August 1st No recurring payments Any person, upon reaching the age of 65 years, or who must retire because of health reasons, and who has been a member in good standing for 10 years, may apply for and automatically receive Life Membership.

Regular Member - $115.00 (USD) Subscription period: 1 year, on: August 1st No recurring payments Hold a Master’s degree or higher with emphasis in Speech-Language
Pathology, Audiology, Speech or Hearing Science, or Education of the
Hearing Impaired; must be a resident of or be employed in Indiana.

Student member - Variable Subscription period: 1 year, on: August 1st No recurring payments Enrolled in an undergraduate or graduate program with a major emphasis in Speech-Language Pathology, Audiology, Speech or Hearing Science, or Education of the Hearing Impaired and shall not be gainfully employed in
any of the above professions except as a recipient of a scholarship or other educational stipend.

THE MISSION OF THE INDIANA SPEECH-LANGUAGE-HEARING ASSOCIATION IS TO ADVANCE THE PROFESSIONS OF SPEECH-LANGUAGE-PATHOLOGY AND AUDIOLOGY THROUGH A COMMITMENT TO ADVOCACY AND PROFESSIONAL DEVELOPMENT.

WE MOVED! PLEASE MAKE A NOTE OF OUR NEW ADDRESS!

ISHA CENTRAL OFFICE ~ 4582 NW PLAZA W DRIVE, SUITE 15 ~ ZIONSVILLE, IN 46077 PHONE: 317-916-4146 ~ FAX: 317-481-1825