You can also download a printable registration form in PDF and fax it to APTA at 303-694-4869.

A confirmation with dialing information and handout materials will be e-mailed to all registered practices by the Friday before the session. 

Registrant Information

Practice/Facility Name

Contact person

Address

City, State, Zip code

Phone

Fax

Email*
                   *Your confirmation will be sent via email.

Number of participants expected to attend from your practice

Registration Fee
The fee includes one dial-in connection. Additional fees will be charged if there are multiple dial-ins.

Select Your Session(s) -- Register for more than one and save $$$:

Tuesday, April 29, 2008    ”BAM! Brand Active Marketing"  (register by April 22, 2008)

Tuesday, May 13, 2008    "Surfing the Sales Pipeline"
(register by May 6, 2008)

One Session Pricing:

$149 for Practices with 4 or more PTs on staff

$139 for Practices with 2-3 PTs on staff

$129 for Practices with only one PT on staff

Two Sessions Pricing (with discount):

$289 for Practices with 4 or more PTs on staff

$269 for Practices with 2-3 PTs on staff

$249 for Practices with only one PT on staff

Payment

VISA

MasterCard

American Express

Check payable to APTA/Colorado Chapter 
      Your check is due within 5 business days of online registration.

Purchase Order include reference number

Cardholder name

Card number include dashes

Expiration date

If paying by credit card, a receipt will be mailed to the contact person and address listed above.

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American Physical Therapy Association / Colorado Chapter
7400 East Arapahoe Road, Suite #211, Centennial, Colorado 80112 U.S.A.
Phone 303.694-4728   Fax 303.694-4869   Email apta@assnoffice.com

Copyright 2006-2008, APTA/Colorado Chapter. All rights reserved. 

(sc 4/5/08)