Register for the Oticon Educational Student Resource Network using the online form below.
Student Contact Information
 

*Required fields
*First Name:
MI:
*Last Name:
*Present Address:
*City:
*Home Address:
*Zip
*Phone: Cell:
Alternate:
*Email:

University:

Personal:
University Affiliation & Information
  *Au.D University / Institution:
  *Expected Graduation Date (MM/DD/YYYY):
  *Have you done a clinical rotation in a clinic or private practice setting?
  *Have you had clinical experience with Oticon hearing devices?
  *Have you attended an Oticon Audiology Camp?
  *Would you like to attended an Oticon Audiology Camp?
Clinical Interest (check all that apply)
  Assistive Listening Devices
  Audiologic Diagnostic Assessments  
  Auditory Processing Assessment and Treatment  
  Aural Rehabilitation  
  Cochlear Implants  
  Electrophysiologic Testing  
  Implantable Hearing Aids  
  Hearing Aid Selection, Fitting and Management  
  Hearing Conservation  
  Industrial Testing  
  Intraoperative Monitoring  
  Pediatric Testing  
  Tinnitus Assessment and Treatment  
  Vestibular Assessments and Rehabilitation  
  Other:
Preferred Professional Setting Post Graduation (check all that apply)
  Clinic (non-profit)  
  ENT Practice  
  Hospital  
  Industrial Audiology Practice  
  K-12 School System  
  Manufacturer/Industry  
  Multi-Specialty Medical Practice  
  Private Audiology Practice*  
  University (Clinician)  
  University (Faculty)  
  VA or Military Hospital/Clinic  
  Other:
  *To what degree is Private Audiology Practice your planned futurepractice setting:
Communication Disclosure
  *By registering for the Oticon Educational Student Resource Network, I agree to accept to receive electronic mail, postal mail and through other communications from Oticon:
 
 
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