Michigan Alliance of School Physical and Occupational Theraposts

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MASPOT Membership

Please print this page and send $10.00 dues payable to MASPOT to:

 Mya Pakonen-Zubal, MASPOT Treasurer
5140 Durfee Road
Eaton Rapids, MI 48827
Membership is from September 1st to August 31st.

MASPOT Student Membership Form

Date:

Name:
Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Fax:
Email:
School District:
Work Facility:
 
OTR PT COTA PTA Student Other

I am interested in volunteering for:
Short Term Project Steering Committe Membership
Task Force Chair
 		 I would like more information
Include my name as a resource person in the directory for the following area(s):
Early Intervention Technology Splinting/Orthotics
NDT Oral Motor/Feeding Transition
Seating SI Transportation
Vocational ED.