SIGNATURES OF SOCIETY MEMBERS (At least 2 required, NOT in same
company nor a spouse or relative of the applicant) vouching for the Applicant who is
expected to abide by and uphold the By-Laws and Code of Ethics of the HASNS.
“I hereby attest that, in my opinion, the applicant whose name appears on this
application is competent to make the required hearing aid selection, to take the ear
impression, and to adjust the hearing aid and earpiece so that they satisfactorily carry out their functions.”