Mailing List Order Form

Click here for a downloadable advertising order form to mail in with your check

Contact Information

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List Information

Purchase Mailing List: $100

Lists may be customized. Please indicate up to 3 fields you'd like to add (member type, state, SIG membership, etc); please note that we are not able to share member emails)

Disclaimer: As a component of the American Physical Therapy Association (APTA), the Academy of Pediatric Physical Therapy abides by policies established by APTA regarding advertising (apta.org/advertisers-exhibitors-and-sponsors/advertising-policies); all advertising must conform to these policies.

To complete your submission, you must make the following certification by checking the "I agree" box below:

I have reviewed these Advertising Policies.

Payment Information

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The APTA Academy of Pediatric Physical Therapy of the American Physical Therapy Association thanks you for your support, as do the children and families who benefit from our services!