Event Registration

Physical Therapist Assistant Information Session

First Name

Last Name

Email Address

Select Phone Type

Mobile Phone

By providing a mobile phone number, I understand that my selected Community College may occasionally send me text messages related to official college business, such as recruitment, advising, registration deadlines, billing, financial aid, etc. I may always opt-out if I no longer wish to receive text messages.

Enter Mobile Phone:
Please use (###) ###-#### format.

Texting Messaging

Select No to opt-out of any official college business: Students may not opt-out of emergency notifications (e.g. weather closures, hazards, etc.)

YesNo

Check if address is outside of U.S. or Canada

Address Line1

Address Line2

City

State/Province

Postal Code

Foreign Address Line

Country

Entry Term

(Spring - Starting Mid to Late January)
(Summer - Starting Late May to Early June)
(Fall - Starting Mid to Late August)

Academic Program of Interest