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Training and Conferences

Registration/Application Request

Pregnancy Postpartum Physical Training (P3T) Train-the-Trainer Leader Course
THIS REGISTRATION IS FOR THE P3T PART 2 RESIDENT COURSE ONLY. ATTENDANCE REQUIRES COMPLETION OF THE P3T PART 1 COURSE. SUBMIT COPY OF PART 1 COURSE CERTIFICATE WITH PART 2 COURSE REGISTRATION. Contact P3T Coordinator if you need assistance to enroll in PART 1, contact info at bottom of this form .
Check the Part 2 Course you plan to attend
   20-24 Oct 2014 at Fort Bliss, TX
   3-7 Nov 2014 at Oahu, HI
   1-5 Dec at Fort Riley , KS
   12-16 Jan at Fort Rucker, AL
   2-6 Feb at Fort Polk, LA
   13-17 Apr at USAREUR
   1-5 June at JBLM, WA (tent)
   20-24 July at Fort Hood, TX
Please provide ALL of the information we ask for - each piece has a purpose. We need your first, MI (if you have one) & last name in the name field please. A first name only is not acceptable.
*Full Name (Last, First):                    
*Job Series/AOC/AFSC:                                  
*Grade/Rank:                                        
*Job Title:          
Component: Army, Navy, Civilian DAC, Air Force, etc:   
 
Gender:   Male   Female
A DVD will be sent to your office after completion of the course. Please provide a complete office mailing address, including the building number or street address. Your home address is not acceptable.
Complete Official Office Mailing Address, Including Unit (BDEBNCO), Building Number, Street Name, Installation, State, Zip Code
                        Commercial Phone Number - REQUIRED:   
           
Work E-Mail Address:   
                       *AKO E-Mail Address:   
1. What is your PPPT program position title? Choose one of the following: Medical Expert, Education Coordinator, Trimester Instructor Trainer, Program OIC or NCOIC   
2. What medical and fitness background/experience do you have? (for example, MFT, medic, nurse, aerobics instructor, degree in fitness-related subject, current P3T EL):
3. Who is responsible for P3T Program Execution at your location?
   Garrison   Installation Commander   Division Surgeon   Brigade   Battalion   MEDDAC   G3
4. Are you on a temporary or permanent profile?   Yes   No
5. If you are on a temporary or permanent profile, what are you restricted from doing?   
6. Do you need to secure funds to travel TDY?   Yes   No
7 Date you are due to PCS from current installation Provide estimate if unknown   
SUPERVISOR information is Required.
Supervisor's Name:   
                Supervisor's Title:   
                Supervisor's Phone Number:    
         Supervisor's E-Mail Address:    
For questions, contact the P3T Program SME at usarmy.apg.medcom-phc.mbx.hpw-webcontacts@mail.mil or by phone at 410-436-4656, DSN: 584-4656