APTEI Report Subscription Form

For A More Effective Physical Therapy Direct Patient Care

"A valuable, effective and time efficient way to stay updated with your clinical skills and relevant research studies."

Full Name:

Mailing Address:

City:                     Province:                     Postal Code:

Country:

Telephone:                               Fax:

E-Mail:

SUBSCRIPTION PAYMENT OPTIONS (Please check the appropriate boxes)

One year /Four (4) issues of APTEI Report = $25.00

I wish to receive the APTEI Reports by: Regular Mail only Both Mail & E-mail

Cheque payable to: APTEI Visa # ________- ________- ________- ________ exp ____/ ____ M/C # ________- ________- ________- ________ exp ____/ ____ Authorization Signature: ___________________________ Date: __________________

Please Print and Send it in.

Please mail or fax this form if paying by credit card or send it with a cheque payable to APTEI (Advanced Physical Therapy Education Institute) To: APTEI 44 Sea Island Path, Thornhill, Ontario, CANADA, L3T 3A4 Toll free & Fax: 1-866-APTEI-44 or 905-707-0819