SPEECH-LANGUAGE PATHOLOGY M.A. PROGRAM APPLICATION FORM

For Fall 2020 Admissions

Combine this Department Application Form with your resume into one (1) .pdf or .docx document

Upload the combined document to Cal State Apply under "Program Materials"-->"CV/Resume"

Your Name:

Baccalaureate Degree:

(Institution) (Major) (Year)

Post-Baccalaureate Degree/ Certificate (only if apply)

(Institution) (Major) (Year)

Other Post-Baccalaureate Degree/ Certificate (only if apply)

(Institution) (Major) (Year)

Completed Coursework in Speech-Language Pathology (SLP)Instructions: List all courses taken or currently in progress to satisfy the prerequisite requirements, including course

number, course title, semester (quarter) taken/expected, letter grade earned, number of credits, and the institution name for each prerequisite course.

Undergraduate course equivalency descriptions are available on the CSULB SLP department website. If not completed, indicate “in progress” and list expected semester. Make sure to list all the additional speech-language pathology coursework.

SLP-Related Subject Area CourseCode Course Title Semester

TakenLetter Grade

# of Credits

Institution Abbreviation

Anatomy & Physiologyfor SLP

Phonetics

Introduction to Language Acquisition

Speech/ Hearing Science

Introduction to Audiology

Aural Rehabilitation

Child Language Disorders

Phonological Disorders

Neurogenic Language Disorders/ Neurology

Multicultural / Multilinguistic Issues

Alternative/ Augmentative Comm.

Motor Speech Disorders

Voice Disorders

Swallowing Disorders

Autism Spectrum Disorders

SLP-Related Subject Area CourseCode Course Title Semester

TakenLetter Grade

# of Credits

Institution Abbreviation

Behavioral Management in SLP

Introduction toClinical Methods in SLP

Clinical Observations/ Professional Writing

List other SLP courses taken or currently in progress (only if applicable)

I hereby verify that the information I have provided is correct to the best of my knowledge.

Signature Date