OKOTA MEMBERSHIP - STUDENT
First Name
Last Name
E-mail
Home Address
Home City
Home State	AL AK AR AZ CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Home Zip
Home Phone
Fax Number
School Affilitation	CKVT OKCC OUHSC MURRAY TCC
Expect Yr of Graduation	2008 2009 2010 2011 2012
OOTA Volunteer Interest	Nominations Annual Conference Committee Recruit & retain members Continuing Education Committee (1day mtgs.) Use website template for announcements Development (Fundraising) Committee Website Assist with meeting registration/set up Recognitions Help with annual conference Promote OT Leadership Development Legislative issues Payment issues and practice issues Adhoc (short-term) committee Mentor student-to-practitioner transition Facilitate an SIS group on (fill in below) Facilitate a workshop on (fill in below)
Any other way you can help
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