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Student Advocacy Day Activities Final Report and Expenses Form

* indicates required field.

State Association Name:*

Date of the Event (MM/DD/YYYY):*

Describe the Event

How many students participated?*

Describe in detail the advocacy event or activity*


What would you change or do differently next time?*

What advice would you have for other states interested in increasing student participation?*

Do you have any suggestions for improving the student advocacy website?

What are your plans to continue to involve students in advocacy day activities?*

*If  you are not planning to involve students in future activities, please explain why?


Note: Receipts (copies or originals) must be submitted to the ASHA National Office. Submit receipts to: Susan Adams, Legislative & Regulatory Advocacy, ASHA, 2200 Research Boulevard, Rockville, MD 20850.

Please provide the amount spent on the following items used to support your student advocacy day activities.




If supplies were used, please describe.




AV Equipment:

Novelties (gifts, merchandise, etc.):

If novelties were used, please describe.


If other were used, please describe.


Completed By First Name:*

Completed By Last Name:*

Today's Date (MM/DD/YYYY):*

ASHA Corporate Partners