Monthly Payments for KOTA Membership
$2.05/mo Students
$4.16/mo Occupational Therapy Assistants
$6.25/mo Sustaining OTA (providing additional support to KOTA)
$6.25/mo Occupational Therapists
$8.33/mo Sustaining OT (providing additional support to KOTA)
$6.67/mo Organizational: Agencies or institutions supporting KOTA
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Kentucky Occupational Therapy Association, INC.
Last Name:
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First Name:
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Phone:
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Email:
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Address ( Street address, City, State, Zip Code)
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Membership Type:
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Occupational Therapist
Occupational Therapy Assistant
Sustaining OT
Sustaining OTA
OT Student
OTA Student
If you are enrolling as a student, when is your anticipated graduation date?
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What are the best times and days to reach you at the phone number you listed above? (Please give several options)
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By submitting this form, I authorize KOTA to contact me via phone to complete my transaction for monthly ACH withdrawals.
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