Orthopaedic Section Membership Form

Please feel free to sumbit this form for new membership in the Orthopaedic Section. The prerequisites for belonging to the Orthopaedic Section is membership in your State Chapter as well as membership in the American Physical Therapy Association. Annual dues for members shall be as follows:

Physical Therapist and Physical Therapist - Post-Professional Student: $50.00
Physical Therapist Assistant, Retired Physical Therapist and Retired Physical Therapist Assistant: $30.00

Student Physical Therapist and Student Physical Therapist Assistant: $15.00

Name:
Practice Name:
Address:
Phone:
Fax:
Email:
APTA Member #:
Membership Type
Please indictate if you are interested in any of the following Special Interest Groups.
Occupational Health
Foot & Ankle
Imaging
Performing Arts
Pain Management
Animal Rehabilitation

Payment Type	Check Credit Card

Orthopaedic Section, APTA, Inc.
2920 East Ave. South Suite 200, La Crosse, WI 54601 | 1-800-444-3982 | 608-788-3965 |