First Year / Second Year “Buddy Matching” Form
 Basic Background Information 
1) Name
[First] [Last]
2) First Year
3) Age
Second Year
5) Where are you from?
4) Birthday
August 4, 2007
[City] , [State]
6) Would you like to be paired
with a person who attended
your undergraduate institution?
7) Where did you attend undergrad?
Yes
[College or University]
No
8) Interests in the field of Speech Path?
Doesn’t Matter
Articulation
Fluency
Social Communication
AAC
Other
Dysphagia
in
[State]
Voice
Language
Cognitive Linguistics
Aural Rehabilitation
[Specify if Other]
 Personal Interests 
9) Is there a population with
which you prefer to work
clinically?
Children
Adults
Not sure yet
10) Were you
active in
NSSLHA?
Yes
No
11) Is there a particular
setting in which you see
yourself working as an SLP?
School
(Specify if Other):
Because we do not concentrate Speech Pathology ALL of the Time………There are a few
other things that I would like to know. They seem silly, but just humor me please!!
12) Fav. Music:
13) Fav. Food:
14) Preferred Recreational Activities :
"[Click here and type something else interesting about yourself if you would like]"

First Year / Second Year “Buddy Matching” Form