EAA On-Line Membership Form

For Renewing Members:

If renewing prior to your membership expiration date, please log-in to renew your membership by clicking here.

If renewing after your membership expiration date, select "Renew" below and enter your membership number. If you do not know your membership number click here to obtain your number.

To select more than one entry in a drop down field, hold down the Ctrl button while making your selections.

Select if this is a New Memberhsip or Renewal after December 31: New: Renewal:

For renewals, enter your EAA Membership Number:
Don't have your new number, click here

Member Information

First Name:
Middle Name:
Last Name
Credentials
Street Address:
City:
State:
Zip:
Country:
Cell Phone Number:
Home Phone Number:
Work Phone Number:
Email:
Omit my name from labels sold for CEUs offerings and profession-related opportunities.
Employer:
Title:
Speech-Language Pathologist  
Audiologist  
Teacher of the Deaf and Hard of Hearing
Highest Degree:
Certifications
Additional Memberships
  Other Memberships-
Enter your ASHA and AAA numbers below for on-line CE Reporting.
AAA Number:
ASHA Number:
Primary Work Setting:
Years in Profession:
Committees:  
Advocacy: Journal:
Conference Planning: Membership:
Research Grants and Scholarships: Professional Development:
Professional Materials Review Board: Social and Electronic Media:
Newsletter:    
 
Payment Information
Regular Member
Available to North American residents, that are audiologists, speech-language pathologists, teachers of students who are deaf and hard of hearing or professionals from related fields who have an active interest in the mission of the association.
International Member
Available to international residents, that are audiologists, speech-language pathologists, teachers of students who are deaf and hard of hearing or professionals from related fields who have an active interest in the mission of the association.
Student Member
Available to students currently enrolled in school to become audiologists, speech-language pathologists, teachers of students who are deaf and hard of hearing or professionals from related fields who have an active interest in the mission of the association.
Life Member
Available to those 65 years and older and that have been an EAA member for 5 or more consecutive years. Note, the fee for Life Membership is a yearly fee. (Please contact the EAA Office for approval for new Life Member requests.)
Affiliate Member
Available to individuals who supply products and services, who are not included in a Corporate Membership.
Corporate Member
Corporate Membership is available for audiology related vendors. Benefits include listings on the EAA website, in the EAR newsletter, advertising discounts, and much more! Each Corporate member may list two persons to receive full EAA membership benefits.
EAA Referal Program
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EAA is an educational organization exempt from taxation under the 501(c) 3 code of the Internal Revenue Service.  Contributions to EAA are deductible as charitable contributions for federal income tax purposes to the extent provided by law.

Questions contact the EAA Office