Graduate Student Forms
Graduate students admitted to the MA program are asked to review these forms before the New Graduate Student Orientation.
- Essential Functions and Graduate Student Handbook Certification Form. This is page 5 of the Essential Functions document.
- Consent to Disclose Student Information Form
- Confidentiality Agreement [PDF]
- Photo and Video Release Form [PDF]
Undergraduate Student Forms
Clinic Student Forms
- Audiological Case History [PDF]
- Communication Tips [PDF]
- Hearing Screening [PDF]
- Hearing Screening Results [PDF]
- Hearing Evaluation Report [PDF]
Clinical Hours Forms
- Record of Supervised Clinical Experiences [excel]
- Summary of Clinical Hours Form [excel]
- Summary of Observation Hours Form [excel]
Student Forms for KACCD Clinics
- Clinical Requirements Checklist
- Hepatitis B Consent/Refusal Form [PDF]
- LiveScan Fingerprinting Form [PDF]
- Physician's Note [PDF]
- No Change in Status (Criminal/TB/CPR)
- Undergraduate Clinic Agreement
Additional forms can be found on the websites of the Office of the Registrar's at http://www.sjsu.edu/registrar/forms/ and the Graduate Admissions and Program Evaluation at http://www.sjsu.edu/gape/forms/.
- Change of Major or Minor Form [PDF] (for students with < 90 units)
- Change of Major or Minor Form [PDF](for students with > 90 units)
- Substitution Form [PDF]
- Undergraduate Graduation Application [PDF]
Advancement to Candidacy
In the second Fall semester, graduate students in the MA degree program will need to submit a Petition for Advancement to Graduate Candidacy form [pdf]. This form must be signed by the CD&S Program Director and submitted to GAPE by the appropriate deadline. Check the deadline for submitting the Request for Candidacy form. Any changes made in the program degree academic plan as listed on the Request for Candidacy form need to be requested using the course substitution form [pdf]. This form must be signed by the CD&S Program Director prior to submission to GAPE.
Application for Graduation
Eligible students can apply for graduation through self-service within their MySJSU account. Instructions to apply will be sent to your MySJSU message center.
Forms for Certification, Licensure, Credentials
To apply for certification in speech-language pathology, click here at https://www.asha.org/Certification/SLPCertification/
CA State Licensure
To apply for licensure through the California Speech-Language Pathology & Audiology & Hearing Aid Dispensers board, click here at http://www.speechandhearing.ca.gov/applicants/slp.shtml
California Teaching Credential
To apply for a speech-language pathology services credential through the California Commission on Teacher Credentialing, click here at http://www.sjsu.edu/education/about-us/departments/cred_office/