PPTA Webinar Registration Form
Name (Contact Person/Organizer(s))
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
If you have all of the information in a one document, please upload here. If not, please fill out all form information below.
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Webinar Sponsor/Co-Sponsor(s) (list all that apply):
i.e. What SIG(s)/Committee(s)/District(s) are sponsoring this webinar
Who and How many individuals are eligible to register?
(i.e. Participating SIG member, PPTA members, Non-members; PT's only, PTA's only)
Title of the Webinar:
*
Speaker(s):
Provide Contact Information: Name, email, phone number.
Do you have Speaker Bio(s)?
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Date
*
-
Month
-
Day
Year
Date
Start Time
*
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10
11
12
:
Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
End Time
*
1
2
3
4
5
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9
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11
12
:
Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
Please describe the course content:
(1-2 sentences or bullet points)
Already have a course content document?
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Cost:
Free (members only)
$10/hr Non-member Fee
Other
Post-test questions with answers
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Where should this webinar be marketed?
Weekly Upcoming Events email
Social Media
PPTA Website
Other
Handouts? (if available): (PDF, Point Point or Word document preferred)
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Do you need a practice session with the Office?
Yes
No
Anything else we should know?
Submit
Should be Empty: