You Are About To Register For The Following Event
Physical Therapy Get Acquainted Day
Date:
1/28/2013
Time:
10:30 AM - 2:30 PM
Event Registration Form
Fields marked with an (*) are required fields.
*
First Name:
*
Last Name:
*
Email Address:
*
Phone Number:
*
Address 1:
Address 2:
*
City:
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State:
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*
Zip/Postal Code:
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County:
Select
Bachelor's degree granted from:
Year of Graduation:
*
Year I plan to enter:
I am interested in attending a class:
Optional Class: Muscle Disuse (8-10 a.m.)
Optional Class: TFA Socket Componentry and Alignment (8-10:30 a.m.)
Optional Lab: Wrist/Hand Manual Muscle Testing Lab (2:30-5 p.m.)
*
Number attending (including myself):
After you click "SUBMIT," you will be asked to review your information before it is submitted to us.
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