ALATA Only Membership Application

Do not complete this application if you are a member of the NATA in good standing. NATA members are automatically granted ALATA membership.

If you are applying for retired membership, contact us at secretary@alathletictrainers.org.

Membership is granted pending verification of State of Alabama Licensure, fees, and approval of the Executive Council.

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

BOC Number

Alabama License Number

NPI Number

Other Healthcare Credential(s)

Membership Category

Certified/Licensed$45

Associate$45

Honorary Student$10

Certified Student$10