Early Membership Access Request
Please complete this form to expedite your membership access. We regularly monitor this form Monday-Friday.
Full Name
*
First Name
Middle Name
Last Name
Membership Email Address
*
example@example.com
APTA Member ID #
*
You will find this in your www.apta.org membership account.
Member Type
*
PT - Physical Therapist
PTA - Physical Therapist Assistants
SPT - Student Physical Therapist
SPTA - Student Physical Therapist Assistant
Select one
*
I am a brand NEW Academy member
I have RENEWED my Academy membership
Membership Join/Renewal Date
*
Membership Expiration Date
*
(Optional) Screenshot of Membership Dues Confirmation
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(Optional) Anything else we need to know?
Example: I just joined on the day a course promo code is expiring and want to use it but unable to login yet. Could you please extend the promo code for an extra day so that I could register once I have my membership activated? Please list the name, dates, location (if in-person) of the course.
Submit Request
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