APTA Clinical Instructor Education and Credentialing Program Saturday & Sunday, May 18-19, 2013 Credentialing Instructor Dawn Blatt, PT, DPT Director of Clinical Education Physical Therapy Program Stony Brook University Hosted by
Rehabilitation
Registration
Registration Form (Please print)
Make check payable to Hospital for Special Surgery
Name
Mail completed registration form and a copy of PT license to: Hospital for Special Surgery Rehabilitation Department 535 East 70th Street New York NY 10021 Attention: Karen Juliano
Address
Phone E-mail
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Participant dossier must be submitted in electronic format to julianok@hss.edu.
Registration Fee
Registration deadline: April 19, 2013
Standard Registration
Cancellation Policy Refund Policy for CIECP Course: Individuals must request a refund 72 hours prior to the date of the course beginning and return the CI manual. The amount of the refund will be equivalent to the APTA portion of the registration fee only.
For more information, contact Karen Juliano, PT tel: 212.774.2481 email: julianok@hss.edu Join the Hospital for Special Surgery Rehabilitation Group on LinkedIn!
APTA Member
$200 APTA Membership #
Non-APTA Member
$250
HSS Rehabilitation Network Member Registration Practice name (required) APTA Member*
$160 APTA Membership #
Non-APTA Member
$200
Make check payable to Hospital for Special Surgery. Registration fee includes APTA Credentialing fee, course documents, and breakfast/coffee, water and snacks each day.