Appalachian Osteopathic Postgraduate Training Institute Consortium

Sign Up / Registration

A-OPTIC Member Registration:

Thank you for taking a few moments to register here at A-OPTIC.ORG. When signing up please make sure to use a valid e-mail address - it will be used as your login and you will receive an email from customer service when your account has been activated.

Email Address:

Confirm Email Address:

Password:

Confirm Password:

First Name:

Last Name:

Organization:
Organization Subscription Key:

Description:

Primary Degree:
If other,

Other Degrees (check all that apply):

	DO		MD
	PHD		ED.D
	Masters
	Other:

Membership Categories (check all that apply):

	WCU-COM Faculty		WCU-COM student
	PNWU-COM Faculty		PNWU-COM student
	Residency Faculty		Residency Staff (Program Coordinator, etc.)
	KYCOM Preceptor		LMU_DCOM Preceptor
	PNWU-COM Preceptor		WCU-COM Preceptor
	Resident
	Other:

AOA Number:

Position (check all that apply):

	Clinical COM Faculty		Basic Science COM Faculty
	Clerkship Faculty		Medical Student
	COM Administration		GME Faculty
	GME Program Director		GME DME
	GME Administrator		Resident
	Intern		Program Coordinator
	ADME
	Other:

Affiliations (check all that apply):

	A.T. Still University of Health Sciences Kirksville College of Osteopathic Medicine
	A.T. Still University of Health Sciences School of Osteopathic Medicine in Arizona
	Arizona College of Osteopathic Medicineof Midwestern University
	Chicago College of Osteopathic Medicine of Midwestern University
	Des Moines University College of Osteopathic Medicine
	Edward Via College of Osteopathic Medicine - Carolinas Campus
	Edward Via College of Osteopathic Medicine - Virginia Campus
	Georgia Campus Philadelphia College of Osteopathic Medicine
	Kansas City University of Medicine and Biosciences College of Osteopathic Medicine
	Lake Erie College of Osteopathic Medicine
	Lake Erie College of Osteopathic Medicine Bradenton Campus
	Lincoln Memorial University DeBusk College of Osteopathic Medicine
	Michigan State University College of Osteopathic Medicine
	Nova Southeastern University College of Osteopathic Medicine
	New York College of Osteopathic Medicine of New York Institute of Technology
	Oklahoma State University Center for Health Sciences College of Osteopathic Medicine
	Ohio University Heritage College of Osteopathic Medicine
	Pacific Northwest University of Health Sciences College of Osteopathic Medicine
	Philadelphia College of Osteopathic Medicine
	Rocky Vista University College of Osteopathic Medicine
	Touro College of Osteopathic Medicine - New York
	Touro University - California Touro University College of Osteopathic Medicine
	Touro University - Nevada Touro University Nevada College of Osteopathic Medicine
	University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine
	University of New England College of Osteopathic Medicine
	University of North Texas Health Science Center at Fort Worth Texas College of Osteopathic Medicine
	University of Pikeville Kentucky College of Osteopathic Medicine
	Western University of Health Sciences College of Osteopathic Medicine of the Pacific
	West Virginia School of Osteopathic Medicine
	William Carey University College of Osteopathic Medicine
	Other:

Replacing an existing account?

Old Username:

Old Password:

Security code: *

Change Image

Enter the characters shown
in the image above: **

- All Fields (except AOA Number) are Required -

A-OPTIC MEMBERS: