Please be sure to submit your dossier, copy of license and APTA card (if applicable) in addition to payment!
Loma Linda University
Marijean Piorkowski, PT, MS, DPT
Lisa Carroll, PT
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 through the IACCC March mailing process.
REGISTRATION CLOSES JANUARY 6, 2017
PAYMENT AND FORMS MUST BE SUBMITTED BY 8PM, FRIDAY, JAN 6TH
Refunds and Cancellations
Cancellations must be received in writing, and will be granted a full refund until January 6, 2017. Cancellations received after 1/6/2017 and up to 1/23/2017 prior to the course will receive a refund, minus a $75 processing fee. Cancellations received 1/23/2017 or later are not eligible for a refund.