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User Information
(e.g., Dr., Mr., Ms., Mrs., Miss, Rev.)
First Name: 
Nickname/Preferred First Name:
Middle Name:
Last Name: 
Suffix (Jr, IV, etc):
(e.g., Jr., Sr., II, III, etc.)
Prior/Alternate/Maiden Last Name:
Email Address: 
Confirm Email Address: 
Have you previously applied to a physical therapy program using PTCAS? Yes
By checking this box, you authorize RF-PTCAS to release your name and contact information to your designated RF-PTCAS programs BEFORE you e-submit your final application to RF-PTCAS. This will allow your designated programs to send you important information about the local admissions process before you complete your RF-PTCAS application:
Account Information
Please choose a username that is between 6 and 15 characters long
Create a unique password that is 6 to 10 characters long. It can include letters, numbers and special characters , _ , -. Password is Case Sensitive. Try to create a password that is easy to remember, but not easily guessed by others.
Confirm Password: 
Security Question: 
Security Answer: