Instructor Registration

(Must be renewed each year.)

Registration
We require some basic information that we will review and use to confirm your employment as an instructor. Please fill in all the information fields below. Click "submit" when done. Registrations with incomplete or inaccurate information will not be processed.

*Indicates Required Fields

ACADEMIC INSTRUCTOR REGISTRATION
Instructor Information:
* First Name:
* Last Name:
 Coding Credentials (e.g., RHIA):
* Position/Title:
* E-mail Address:
* Retype E-mail Address:
* Phone Number:
XXX-XXX-XXXX
Mailing Information:
Insitution Name:
Department:
Street Address:
Street Address 2:
City:
State:
Zip:
Textbook Information:
Title of Book Requested:
Course Name:
Number of Students:
Number of books ordered:
* Books will be purchased from:
AHA Press National Coding Training Advisory Team

The Advisory Team consists of academic program directors committed to the profession. Members provide critical feedback on existing AHA Press textbooks and materials and collaborate with AHA Press editorial staff on items in development. The Advisory Team is not affiliated with the AHA Central Office; however, team members share input with AHA Central Office staff. We welcome new team members. Please indicate if you would like to be considered to become an advisory team member.

Yes, I would like to be considered.