Hand Therapy Association of California



When things go wrong: How to right a wrong Learn how surgeons and therapist correct mistakesMarch 29th – 30th 2019SAN JOSE, CA* Mandatory Fields* E-Mail:___________________________________ (communication will be made through this email)*First Name and Last Name: ___________________________________________(As you want it to appear on your certificate)*Credentials: ________________________ *License Number: _________________Address: ________________________________ _________________________________Member for 2019 HTA-Ca: Yes: ___ No:___ Want to become a member and save: Yes: ___ No:___ Add: $ ___ membership duesMeal Preferences: Veg: __ Non Veg: __ Other: _______________How did you hear about us: HTA-CA blast: __ website:___ ASHT website: ___ Friend/ Colleague: ___ FB/ LinkedInSigning up with colleagues/ Friends for additional discount (Early Bird Only): Yes: ___ No:___If yes: List at least 1 of your colleague: _________________________, ____________________Early bird: Feb 20th 2019___I am a member: $475 ___ I am signing up with colleagues: $ 450___I am a non member: $550___ I am signing up with colleagues: $ 525Late registration: After Feb 20th 2019____$ 550 for members ____$600 for non membersNon licensed Student with IDEarly bird: Feb 20th 2019 ___ $350Non licensed Student with IDLate registration: Feb 20th 2019 ____ $ 450 Post it on Social Media Linked-In and Facebook and provide proof to get a drink ticket free Please write check payable to Hand Therapy Association of California and mail the check to Diane Coker, 23786 Brant Lane, Laguna Niguel, Ca 92677 ................
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