AAT Pledge
Please read and select each checkbox. 
By submitting this form I agree to uphold the following pledge:
Email *
Name *
First and last name
POCA username (if you haven't joined POCA yet, please do so now. If someone else will be paying for your Punk level membership, please join as a House Guest. Your membership will be upgraded once payment is received).  *
Date of Training, Training Location, Trainer(s) name *
As a POCA Auricular Acu-Technician (AAT), I understand, agree, and attest that I:  *
A copy of your responses will be emailed to the address you provided.
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This form was created inside of People's Organization of Community Acupuncture.