Legislator RSVP Form - PT Day at the Capitol 2010


First Name *
Last Name *
Legislative District *
Telephone Number *
Email Address *
I Will Attend the Luncheon *
Yes
No
I Will Bring a Member of My Staff to the Luncheon *
Yes
No
I Will Participate in the Fitness Clinic *
Yes
No





Arizona Physical Therapy Association
3933 South McClintock Drive, Suite 505
Tempe, AZ 85282
602.569.9101 or 800.264.APTA (2782)
Fax: 480.603.4141
 
info@aptaaz.org