PLACT Registration Form

New Dates TBA.
- Registration for each clinic ends at 5:00PM the day before the clinic. Online clinics have a maximum limit of 75 participants and require a minimum of 10 participants. If you do not see the date you wanted, that clinic has either reached max capacity or the registration deadline has passed. If the clinic you register for does not meet the minimum number of participants you will be notified by email that the clinic has been cancelled.
  
  You will receive an email with the zoom link and course materials prior to the start of an online clinic. Please make sure the email listed below is accurate. If you do not receive this email by 12:00PM the day of your clinic (for evening clinics) or by 7:00PM the day before your clinic (for morning clinics) please email [email protected].
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Choose the Clinic Date You'd Like to Register for REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parish REQUIRED Please fill out this field.
  
  List Parish if "OTHER" Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Submit
  
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