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PIAA Regional Courses
01/12/2012 - 02/15/2012
 
2012 Spring Conference
04/13/2012 - 04/15/2012
 
2012 Fall Conference
08/17/2012 - 08/18/2012
Alabama APTA Conference Attendee Registration Form
Attendee Information
First Name: *
Last Name: *
Professional Designation:
Address Line 1: *
Address Line 2:
City: *
State: *
Zip Code: *
Work Phone:
Fax Number:
Email Address:
Member Number:
Member Status: *
Classification: *
Clinical Course Sign-Up
Course Title Choose
One
Hip and Butt Pain: A Medical and Physical Therapy Conundrum
Improving Clinical Practice with Objective Functional Outcome Measures
Essentials Of Pediatric Practice: The Lifespan Approach
Choose All That Apply
Course Title
Professional Issues in Physical Therapy (free and open to all)
Reception and Awards Presentation (free and open to all)
Lunch & Chapter Business Meeting (Lunch is free with conference registration. Lunch fee for non-registrants is listed below. lunch purchase not required to attend the business meeting)
Conference Fees
PT Member $325
PTA Member $225
Student Member $50
PT Nonmember $400
PTA Nonmember $300
Student Nonmember $75
Lunch for non-registrants $15
After August 11th, a $5 registration fee will be added for students
and $25 for everyone else.
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