Alumni Membership Application

Eligibility An alumnus is defined as being a Past President of a state speech‑language‑hearing association who is currently not on the state association board. Alumni membership is open to past presidents of their state association as long as they don’t rejoin their board in a president/president-elect/past president (3P) capacity. If that happens, the CSAP Alumni member must remove himself/herself from the group until they are no longer serving in a 3P capacity with their state association. Alumni members are not eligible to be an Officer, Commissioner or Committee Chair of CSAP and are not permitted to vote in CSAP elections or Business Meetings.
First and Last Name *
Mailing Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Email *
Phone
Noted phone above is
Home PhoneCell PhoneWork Phone
State Association you belonged to *
Most Recent Office Held *
Term End Date *
Are you currently on your state association Board of Directors *
YesNo
If you selected Yes above, what is your position on the board?
Are you planning to attend either of the 2021 CSAP Conferences?
Both Spring and Fall ConferencesSpring only (Richmond, VA)Fall only (Washington, DC)I cannot attend either Conferences this year

Payment - $25 *
Alumni Membership: $25 annuallyCheck (Payable to CSAP. Mail to 700 McKnight Park Drive, Suite 708, Pittsburgh, PA 15237)Credit Card (Visa, MasterCard, Discover, American Express)
Credit Card Number
Expiration Month
Expiration Year

700 McKnight Park Drive, Suite 708
Pittsburgh, PA 15237
855-727-2836
888-729-3489 fax
csap@robertcraven.com