Phone: (800) 277-8737
(864) 288-3536
FAX: (800) 978-7379
(864) 288-3380
Int. Ph.
Int. Fax		 001-864-288-3536
001-864-288-3380

  

Super Duper® Publications
  P.O. Box 24997
  Greenville, SC 29616 USA
 


Speech-Language Pathologist Application
for Assessment Administrators

     Super Duper® Publications is looking for licensed, Masters level, Speech-Language Pathologists with their CCCs (no CFYs) in the United States and Canada to assist with the standardization of new assessment instruments. Listed below are our requirements. You must have:

  • an e-mail address and daily access to the address;
  • access to a fax machine;
  • experience administering assessment instruments and interpreting results according to a protocol;
  • the ability to maintain ongoing contact with Super Duper® and its SLP staff.

     In exchange for your help, you will receive a free copy of the test when it is published, acknowledgment in the testing manual, and a gift certificate.

     If you are interested in becoming an Assessment Administrator, please complete the form below.

(NOTE! Required Information is highlighted in red).
First Name:      Last Name:
  ASHA Member? Yes No
  CCC-SLP? Yes No
  State License Yes No
Place of Employment:
Employment Address:
City:
State: Zip: Country:
County: District:
Daytime Phone: Fax: 
Primary E-mail:
Secondary E-mail:
Home Address:
City:
State: Zip:   Home Phone:
To which address would you like materials shipped?
Work
Home
Place a check next to your area(s) of testing interest.
Articulation Language Fluency All
In the table below, indicate the ages of children you can test.
Under 2
  6.0 - 6.11
2.0 - 2.11
7.0 - 7.11
3.0 - 3.11
8.0 - 8.11
4.0 - 4.11
9.0 - 9.11
5.0 - 5.11
Over 9
In the table below, indicate the population(s) of children you can test.
African-American
  Caucasian
Asian
Native American
Hispanic
 
Low SES
Median SES
High SES
 



**Super Duper® will never pass your information to a third party.**
© Super Duper® Publications. All rights reserved.