Arkansas Speech-Language-Hearing Association

ArkSHA Membership Renewal
  1. Membership dues are not deductible as charitable contributions for federal income tax purposes. In addition 15 % of your dues spent for governmental relations are not deductible as a business expense.
  2. First Name(*)
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  3. Middle Name
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  4. Last Name(*)
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  5. Membership Categories(*)




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  6. Renewing Member Late Fee
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  7. Credit Card Convenience fee
    $3 Credit Card Convenience Fee
  8. Total
    $0.00
  9. SLP/AUD # (students put 0)(*)
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  10. Home Address
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  11. City
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  12. State
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  13. Zip
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  14. Home Phone
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  15. Email Address(*)
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  16. Work Setting (check all that apply)
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  17. Place of Employment
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  18. Address
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  19. City
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  20. State
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  21. Zip
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  22. Work Phone
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  23. Academic Degree
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  24. Certification/Licensure (check all that apply)
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  25. * Membership dues are not deductible as charitable contributions for federal income tax purposes. In addition 21 % of your dues spent for governmental relations are not deductible as a business expense.