2 Steps to Joining QSHA:

STEP 1. Complete the form below and click SUBMIT. If you have any difficulties submitting this form please contact Stacie M. Greene.
(Information in this form will be included in the QSHA Membership Directory which will be available to members from the Members only area of this site.  Please indicate any information that you do not want listed in the Membership Directory in the COMMENTS box.

STEP 2.  Pay your dues online via Paypal (Paypal account, bank account, or credit card)

OR

Membership fees may be paid in person at QSHA sponsored workshops.  The membership form must be completed online



The Members page password will be sent to the email you enter below when you have completed both steps. 

REMINDER:  You must complete BOTH STEPS to become a QSHA member

Don't forget to go to http://www.ishail.org/isha/Join_ektid352.aspx and join the Illinois Speech-Language-Hearing Association. QSHA must have 20% of its members be ISHA members in order to continue to provide CEUs so join today!
QSHA Membership
First Name:
Last Name:
Address Street 1:
City:
Zip Code: (5 digits)
State:
Email:
Daytime Phone:
 Area of Practice: SLP
AUD
Employer:
Membership Status:
New Member
Returning Member
Indicate all memberships:
ASHA Member
ILSHA (Illinois) Member
ISHA (Iowa) Member
Comments:


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