Certified Provider Application
Thank you for applying to become a Carnegie Learning Certified Provider. Your passion truly inspires us and we are grateful to be able to collaborate with professionals like you!

Providers include (i) speech and language pathologists, educational therapists, psychologists and similar health care professionals, for use in such professionals’ own private practices; (ii) private speech therapy and other private health care clinics, for use under the supervision of such clinics’ professionals; (iii) public and private hospitals, for use under the supervision of such hospitals’ professionals; (iv) government service agencies for use under the supervision of such agencies’ professionals; (v) public and private schools for adults and children, including but not limited to elementary and secondary schools, colleges, tutoring and after school programs, language schools and remedial training schools, for use under the supervision of such schools’ professionals; and (vi) after school learning centers (“Authorized Administrators”).  

By submitting this application, you attest to being a licensed professional in one of the categories outlined above.  

If you are still in the research phase of this process, we invite and encourage you to email the Provider Channel Manager, Catherine Kuklinski at ckuklinski@carnegielearning.com to schedule a Q&A call.

Your Application Roadmap

1) Completing the application below will take approximately 10-12 minutes, as a part of submitting the application below, we ask for a resume or CV.
 
2) If your application is approved, you will receive an email to schedule an interview with our Provider Channel Manager.

3) Once your interview is complete, you will receive an email within 24-48 business hours, with either "Approved," "Not Approved," or "Pending Clarification."

4) The Provider Channel Manager will contact you to complete and sign the Administrator Agreement for partnership execution.

5) Upon execution of the Administrator Agreement, you will be contacted regarding payment and online training certification.

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Your full name *
Your title *
The best number to reach you *
Your company's name *
Your company's website *
Your company's phone number *
Your company's email *
Your company's full address (street, city, state, zip, and country) *
What setting do you work in? *
The below list represents the populations who benefit from Fast ForWord. Which populations do you work with? *
Required
Which age groups are you targeting for Fast ForWord? *
Required
Below is a list of skills that are developed by Fast ForWord. Which skills are you and your clients targeting for development? *
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In your view, what range of clients that you work with, could benefit from Fast ForWord at any given time throughout the year? *
Fast ForWord is a supplemental tool, designed to optimize and complement the services that Certified Providers offer the families they work with. How do you envision implementing Fast ForWord into your current package of services? *
In order to generate results, Fast ForWord will identify the area of need and challenge the client to develop this area.  Because Fast ForWord will challenge a weak skill, it is normal and expected for clients to experience fatigue and frustration; this means they are on the right track!  In order to generate optimal results, clients will have to work in Fast ForWord for 5 days per week, 30 minutes per day. How will you ensure and support your clients in maintaining this suggested minimum protocol? *
Please email your resume or CV to the Provider Channel Manager at ckuklinski@carnegielearning.com *
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