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Membership Application

This form is for prospective members who are applying to be a member of the Canadian Academy of Audiology (CAA) for the first time. If you are currently a member looking to renew your membership or are a past member looking to re-apply, please click here.

  • *Preferred Mailing Address Home Work
  • *First Name
  • Initial  
  • *Last Name

Home

  • *Country
  • *Street
  • *Phone
  • *City
  • *Prov/State
  • *Postal/Zip
  • Fax
  • *Email

Work

  • *Practice Type
  • *Company/School
  • *Country
  • *Street
  • *Phone
  • *City
  • *Prov/State
  • *Postal/Zip
  • Fax
  • *Email
  • *Language PreferenceEnglishFrench
  • I agree to have my information listed in a membership directory
  • I agree to have my information listed in "Find an Audiologist" on the Canadian Academy of Audiology website

*Please Select One:

  • Full Member: $180.00 CDN + Applicable Taxes
  • Full membership applies to those 1) who hold a graduate degree in Audiology from a Canadian university and/or, 2) who are licensed by a province or territory to practice audiology in Canada.
    Please provide your provincial registration number or proof of degree.
    Degree Held
  • Affiliate Member: $125.00 CDN + Applicable Taxes
  • Affiliate membership applies exclusively to professionals from related fields that do not hold a graduate degree in audiology. New registrants: please provide professional permit or proof of degree
  • International Member: $84.00 CDN + Applicable Taxes
  • International membership applies to those who reside outside of Canada and possess formal academic training and/or clinical or research experience in the area of audiology, or a related field.
  • Retired Member: $84.00 CDN + Applicable Taxes
  • Retired membership status applies to those previously licensed to practice audiology in Canada and have left the workforce with no intention of re-entry.
  • Student Member: $30.00 CDN + Applicable Taxes
  • Student membership applies to those who are currently enrolled in a graduate program in Audiology or a related field. Please provide proof of enrolment.
    *University Student Number
  • *Payment Method
  • Visa
  • Mastercard
  • Cheque/Money Order

Personal information collected on this form is used exclusively by the Canadian Academy of Audiology (CAA) for membership purposes only. Information will not be released to any other parties without express consent.