Application for Non-ASPT CEU Approval
Use for Option #2:
Submit 2 weeks prior to applying for
membership renewal
(PRINT PLAINLY)
Last name ________________________________

First name ________________________________

Address _________________________Apt. _____

City __________________ State _____ Zip ________

Day Phone (_____) _____ -_________

_______________________________
Membership # (required)

Social Security # (optional)________-_____-_________

Send CEU's and $20.00 fees to:

AAHS
P.O. Box 2844
Hickory, NC 28603

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Contact ASPT at:

email: office@aspt.org
Phone: 828-294-0078
Fax: 828-327-2969

Visit our website at www.aspt.org to see our CEU day schedule for 2007, T-shirts and Pins!