Please be sure to submit your dossier, copy of license and APTA card (if applicable) in addition to payment!
Presbyterian Intercommunity Hospital
Sharon Kunde, PT, MS
Georgeanne Vlad, PT, MA
PLEASE DO NOT REGISTER ONLINE IF YOU INTEND TO PAY BY CHECK! Thank you.
To register, each participant must submit via email or fax: dossier, license and, if applicable, APTA card:
1. Dossier typewritten. (download form here Participant Dossier Word.doc ) APTA WILL NOT ACCEPT HANDWRITTEN DOSSIERS.
2. Copy of state license to practice
3. Copy of current (as of date of course) APTA membership card, if applicable.
4. Registration fee-- check payable to IACCC, or payment on IACCC website via Paypal.
Mail check to:
IACCC CCIP Administrator
1540 East Alcazar Street, CHP-155
Los Angeles, CA, 90089-9006
**IACCC Affiliate Facility members
$160 (APTA member) $250 (non APTA PT, non APTA PTA)
$300 (non-PT or non-PTA)
Non-IACCC Facility Members
$275 (APTA member) $400 (non APTA PT, non APTA PTA)
$465 (non-PT or non-PTA)
**An IACCC facility is one who takes students from 2 or more IACCC schools AND schedules students through the IACCC yearly March mailing process.
REGISTRATION CLOSES June 17th, 2016
Refunds and Cancellations
Cancellations must be received in writing, and will be granted a full refund until June 15, 2016. Cancellations received after June 15, 2016 and up to July 1, 2016 prior to the course will receive a refund, minus a $75 processing fee. Cancellations received July 2, 2016 or later are not eligible for a refund.