Join TAPIT

NOTE: If you prefer to join TAPIT using the U.S. Mail please download and fill out the registration form and mail it along with your check.

Membership Type
Please choose from a membership type*
Membership Type Notes:
  • Student 1 Year [$25.00]:
    At least nine (9) hours of coursework per semester.
  • Individual 1 Year [$50.00]:
    Regular Membership
  • Corporate 1 Year [$75.00]:
    Covers up to five (5) staff members
  • Institutional 1 Year [$150.00]:
    Covers six (6) or more staff members
Personal Info
Username*
Photo
Password* Password* (confirm)
First Name* M. Initial
Last Name*
Business Display on site?
Address Display on site?
City Display on site?
State* Zip
Phone* Display on site?
Phone
(home)		 Display on site?
Phone
(fax)		 Display on site?
Phone
(cell)		 Display on site?
Email* Display on site?
Email*(confirm)
Biography:
Display Biography on site?

Education (degree and institution is possible:
Display Education on site?

Currently a student?
Available for work?
Languages

Enter up to 5 language combinations. More combinations can be added once your account is created.

Service
From To
Be used for medical?
Service
From To
Be used for medical?
Service
From To
Be used for medical?
Service
From To
Be used for medical?
Service
From To
Be used for medical?
Professional Credentials
Federally Certified?
State Certified?
State Registered?
ATA Certified?
Other?
I certify the above information is correct to the best of my knowledge.*