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.Registration Fees
**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.
Discounted rates are available for facilities registering more than 5 employees for the same course. Discounts are applied to the applicable participant rate. All group registration must be sent together:
10% for groups of 5-9
15% for 10-14
20% for 15 or more
Send all registration materials to:
IACCC CCIP Administrator
1540 East Alcazar Street, CHP-155K
Los Angeles, CA, 90089-9006
PAYMENT AND FORMS MUST BE SUBMITTED BY 8PM, TUESDAY, JANUARY 2ND, 2018
Refunds and Cancellations
Cancellations must be received in writing, and will be granted a full refund until January 2, 2018. Cancellations received after 1/2/2018 and up to 1/15/2018 prior to the course will receive a refund, minus a $75 processing fee. Cancellations received 1/15/2018 or later are not eligible for a refund.