2021 RT Week Promo Order Form

Name*
First Last
CSRT ID#
Daytime Phone Number*
Email*
Enter Email Confirm Email
Hospital / Organization Name
Shipping Address*
Street Address Address Line 2 City Province Postal Code
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Quantity of Wall Calendar - Bilingual*
Please enter a number from 0 to 3.
Max of 3 per request.
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Quantity of Leaflet: "What is an RT?" - Bilingual*
Please enter a number from 0 to 15.
Max of 15 per request.
Respiratory Therapist Sticker – Circle*
Please enter a number from 0 to 3.
Max of 3 per request.
Respiratory Therapist Sticker – Rounded Square*
Please enter a number from 0 to 3.
Max of 3 per request.