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Texas Interprofessional Education (IPE) Consortium

Name & Email Address

First Name
Middle Initial
Last Name
Email Address
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Please use your academic or employee email account. Email addresses from public email providers like Yahoo, Facebook or Gmail.com will not be accepted.

Include my name in the membership directory

By providing your e-mail and mailing address you agree to receive e-mails and/or mail from the Texas IPE Consortium.

While only your name, email address, and password are required, it is very helpful for our reporting purposes if you would supply as much of the optional information as possible.

Telephone

Work
Mobile

Organization Details

Academic Credentials

Consortium Member Institution If you are not associated with an active member institution, you do not get a discount for attending events. Choose non-member if you are not associated with a member institution.
Non-Member Institution

I am a member of the institution I have selected, but I don't have an email address issued by that institution

Department
Title
Position Types (check all that apply

Faculty Member

Practitioner

Staff

If other position type, please clarify
Profession
Dietary restrictions or food allergies
Password

Thank you for registering for the Texas Interprofessional Education (IPE) Consortium