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VERIFICATION OF LICENSE IN OTHER STATE SOUTH DAKOTA BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY 810 North Main #298 Spearfish, SD 57783 (605) 642-1600 To the Applicant: Complete this side of

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1. Start by gathering all the necessary information and documents required to complete the applicant form. This may include personal identification documents, academic records, employment history, references, and any other relevant information requested.
2. Carefully read and understand the instructions provided with the applicant form. Make sure you are aware of any specific guidelines or requirements for filling out the form.
3. Begin by providing your personal details accurately. This may include your full name, date of birth, contact information, and address. Double-check the information for any errors or typos.
4. Complete the sections related to your educational background. Provide details about your academic achievements, degrees earned, and educational institutions attended. Include the dates and any relevant coursework or specialization.
5. Fill out the sections related to your employment history. List your previous employers, job titles, dates of employment, and a brief description of your responsibilities and accomplishments in each role.
6. If applicable, include any additional certifications or qualifications you possess that are relevant to the application. This can include professional memberships, licenses, or specific training completed.
7. Provide accurate and up-to-date references as requested. Include the contact information for individuals who can vouch for your qualifications, skills, and character. It is important to obtain their permission before listing them as references.
8. Make sure to review all the information you have provided before submitting the completed form. Check for any errors, missing information, or inconsistencies. Proofread for grammar and spelling mistakes.
9. Depending on the application requirements, you may need to sign and date the form before submitting it. Follow the instructions provided on how to finalize the application process.

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