Title of Program:
(limit to 70 letters/spaces)

Date(s) of Program:

Course Location: (enter City only)

Program Content Intended For:
Audiologists
Speech-Language Pathologists
Both

Presenter(s) name, affiliation, and brief
description of qualifications:
If the Presenter has previously been approved,
or if you don't know, click here to select from
a list of approved presenters.
(Limit 255 Characters)

Program Description and Overall Goal:
(why this course is needed and how it will address the need)

Educational Objectives: (as a result of this course participants will be able to...)

Instruction Method and Course Materials to be used: (lecture, powerpoint, videos, handouts, discussion, etc.)

I will use:    TSHA Evaluation Form     Our Own Evaluation Form

Please    Do   Do Not    publish in the CE Calendar

Has this program been previously approved by TSHA?
Yes    No

Continue