Lead & Learn Night Submission Form

A one hour monthly discussion to motivate, inspire and inform PTs, PTAs, and students of physical therapy.

Each L&L Nights will run from 6:00 pm – 7:00 pm with 30 minutes of networking to follow.

This is free for members

Name of Contact(Required)

First Last

Company

Do you need a location to present or would you like us to ask if a local practice can host?(Required)

If location secured, please note the address

Preferred month(s)(Required)

Presenter Information(Required)

Description of product or topic(Required)

We will use this information to advertise the event

Logo or Flyer Upload for Advertising

Max. file size: 300 MB.

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