SPEECH-LANGUAGE PATHOLOGY M.A. PROGRAM APPLICATION...
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SPEECH-LANGUAGE PATHOLOGY M.A. PROGRAM APPLICATION FORM Department of Speech-Language Pathology California State University, Long Beach • Combine this Department Application Form with your résumé into one (1) .pdf or .docx document • Upload the combined document to Cal State Apply under "Program Materials"-->"CV/Résumé" Name: ___________________________________________ Date of Application: _________________ Cellphone #: ____________________________ Home phone #: ________________________________ Email: ______________________________________________________________________________ Mailing Address: ____________________________________________________________________________ (Street) (City) (State) (Zip code) Baccalaureate Degree: (Institution) (Major) (Year) Other Post-Baccalaureate Degree/ Certificate (if apply) (Institution) (Major) (Year) Other Post-Baccalaureate Degree/ Certificate (if apply) (Institution) (Major) (Year) • Date Cal State Apply application comp • Date GRE taken: ______________________________________________ Were GRE scores sent directly to the University from ETS? Yes No GRE Score: Verbal ________________ Writing ________________ Quantitative _______________ • GPA for Speech-Language Pathology coursework _____________________ • Your overall GPA _____________________ 1
Transcript of SPEECH-LANGUAGE PATHOLOGY M.A. PROGRAM APPLICATION...
SPEECH-LANGUAGE PATHOLOGY M.A. PROGRAM APPLICATION FORM
Department of Speech-Language Pathology California State University, Long Beach
• Combine this Department Application Form with your résumé into one (1) .pdf or .docx document• Upload the combined document to Cal State Apply under "Program Materials"-->"CV/Résumé"
Name: ___________________________________________ Date of Application: _________________
Cellphone #: ____________________________ Home phone #: ________________________________
Email: ______________________________________________________________________________
Mailing Address: ____________________________________________________________________________ (Street)
(City) (State) (Zip code) Baccalaureate Degree:
(Institution) (Major) (Year)
Other Post-Baccalaureate Degree/ Certificate (if apply)
(Institution) (Major) (Year)
Other Post-Baccalaureate Degree/ Certificate (if apply)
(Institution) (Major) (Year)
• Date Cal State Apply application comp• Date GRE taken: ______________________________________________
Were GRE scores sent directly to the University from ETS? Yes NoGRE Score: Verbal ________________ Writing ________________ Quantitative _______________
• GPA for Speech-Language Pathology coursework _____________________• Your overall GPA _____________________
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Relevant ExperienceProvide a written statement of significant experience related to the field of speech-language pathology. This statement is to be no more than 500 words in length and will be evaluated on relevancy of experience and grammatical composition.
• You may discuss research or relevant experience, such as working as a research project assistant,SLP assistant (SLPA), ABA specialist, etc.
• If relevant experience and/or research have not been completed, you may describe your reason(s)for pursuing graduate studies in the field of speech-language pathology.
Number of words:
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Course Equivalency Worksheet
(a) List all courses taken or currently in progress to fulfill the prerequisite courses. Please
include course number, course title, letter grade, number of credits, earned grade points,
and semester (quarter) taken, and the institution name for each prerequisite course.
(b) Undergraduate course descriptions are available on the CSULB SLP graduate program
website. http://web.csulb.edu/colleges/chhs/departments/speech-languagepathology/
student-resources/
(c) If not completed, indicate “in progress” and list expected semester.
(d) You can only list a course ONCE on the form. If you list the same course twice on the
form, it may affect your application review negatively.
(e) Use the blank rows/columns for additional speech-language pathology coursework taken
or in progress.
(f) Calculation of Grade Point Average (GPA)
i. Calculate your GPA from the SLP classes on record.
ii. Use the Grade Point Average (GPA) Scale below to calculate your GPA
Letter
Grade
Grade
Points
Letter
Grade
Grade
Points
Letter
Grade
Grade
Points
Letter
Grade
Grade
Points
A+ 4.3 B+ 3.3 C+ 2.3 D+ 1.3
A 4.0 B 3.0 C 2.0 D 1.0
A- 3.7 B- 2.7 C- 1.7 D- 0.7
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Prerequisite SLP Courses Course
Code Course Name
Semester
Taken
Letter
Grade
# of
Credits
Earned
Points
Institution
Name
Example: Phonetics CD 271 Phonetics Fall 2014 A 3 4x3=12 CSULB
Anatomy & Physiology for SLP (e.g. CD 261)
Phonetics (e.g. CD 271)
Introduction to Language Acquisition (e.g. CD 329)
Speech/ Hearing Science (e.g. CD 330)
Introduction to Audiology (e.g. CD 373)
Aural Rehabilitation (e.g. CD 440)
Child Language Disorders (e.g. CD 481A)
Phonological Disorders (e.g. CD 456)
Motor Speech Disorders (e.g. CD 466)
Voice Disorders (e.g. CD 476)
Swallowing Disorders (e.g. CD 477)
Neurogenic/ Acquired Language Disorders (CD 481B)
Assessment in Speech-Lang Pathology (e.g. CD 483)
Clinical Observations/ Professional Writing (CD 489)
Autism Spectrum Disorders (e.g. CD 485)
Alternative/ Augmentative Comm. (e.g. CD 472)
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Prerequisite SLP Courses Course
Code Course Name
Semester
Taken
Letter
Grade
# of
Credits
Earned
Points
Institution
Name
Multicultural / Multilinguistic Issues (e.g. CD 460)
Behavioral Management in SLP (e.g. CD 464)
� GPA of Speech-Language Pathology Coursework:
________ (Sum of Earned Points) ÷ ________ (# of SLP credits taken) = ________
I hereby verify that the information I have provided is correct to the best of my knowledge.
Signature Date
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