TouchChat Partner Application
First Name
*
Last Name
*
Email Address Associated with your PRC-Saltillo Account
*
Confirmation Email
Please provide the email address you used to complete the app partner learning requirements.
Country
*
Please Select
Argentina
Barbados
Canada
Chile
China
Israel
Japan
Peru
Philippines
South Africa
Taiwan
Thailand
Trinidad and Tobago
Turks and Caicos
United Arab Emirates
United States
Province / Territory
*
Please Select
Ontario
Quebec
Nova Scotia
New Brunswick
Manitoba
British Columbia
Prince Edward Island
Saskatchewan
Alberta
Newfoundland and Labrador
Northwest Territories
Yukon
Nunavut
ZIP Code
*
Postal Code
*
Consultant Lookup
Consultant
Professional Details
Job Title
*
Please Select
Speech Language Pathologist
Assistive Technology Specialist
Occupational Therapist
Physical Therapist
Teacher
Speech Language Pathology Assistant
Organization/Employer
*
Please enter the full name of your organization.
Professional License Number
*
Please list the specific AAC services you provide and include a detailed description of how you intend to use the app upgrade in your clinical practice, educational setting, or service delivery.
*
0/250
Learning Requirements
When did you complete the TouchChat Partner Program eLearning course in AAC Learning Journey?
eLearning Completion Date:
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Note - Course completion will be verified.
Please enter the dates you completed the following graduate SLP student requirements:
Acknowledgements
Please verify that you are human
*
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