APTA Orthopedics Involvement Form

1.YES! I want to get involved in the APTA Orthopedics! I’m most interested in (check all that apply):
2.I am interested in participating/working with the following Special Interest Group(s):
3.I am interested in participating/working with the following engagement communities:
4.What is your preference regarding time commitment during involvement?
5.Do you have any experience working with committees, task forces or special interest groups? If yes, please list below:
6.Your name:(Required.)
7.Your APTA ID number:(Required.)
8.Your Mailing Address:
9.Your email address:(Required.)
10.Your daytime phone:
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