Toggle navigation
Home
About
Patients
Treatments
Locations
Therapists
Events
Careers
Welcome to Advanced Physical Therapy Center
Request Appointment
...read
a success story.
Patient Success Stories
Dynamic Running/Walking Warm-up
×
Contact Us
First Name
Last Name
Phone
Email
Message
Request a Sponsorship
Requestor First Name
Requestor Last Name
Date of Event or Activity
Length of Event
Type of Event
Is this sponsorship tied to a charitable organization?
Yes
No
Expected turn out for the event/ fundraiser
If so, which one?
Where do proceeds go?
Charitable or Tax ID Number
Title or role within the organization
Other contact name if different from requestor title:
Best phone number to call:
Email
Relation to APTC?
Current or Past Patient
Employee
Community Member
Amount Requested
Deadline for payment
- Month -
January
February
March
April
May
June
July
August
September
October
November
December
Purpose of event/fundraiser
- Day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
If approved, what will you need from APTC besides the monetary donation?
ie: Volunteers, Print Ads, Signage, etc.
Upon request, do you have a flyer or other promotional materials available?
- Please Select -
Yes we have a flyer
No we do not have a flyer
List what is included in this sponsorship Opportunity
Other information pertinent to request:
Submit
Copyright 2020 Advanced Physical Therapy Center
GOOD FAITH ESTIMATE NOTICE
NOTICE OF NONDISCRIMINATION
PRIVACY POLICY
