DVD ORDER FORM

Law and Ethics

Name

Company/Organization Daytime Telephone

Mailing Address (for official receipt) E-Mail Address

APEGBC System ID #
___ ___ ___ ___ ___ ___
Designation
 P.Eng.  P.Geo.  EIT  GIT  Applicant

 Please update my contact info in the database Office Use Only

Fee Options (choose one below) Shipping Method

 Law & Ethics $345.00 + 7% PST and 5% GST =
$386.40
 Law Session $189.00 + 7% PST and 5% GST =
$211.68
 Ethics Session $189.00 + 7% PST and 5% GST =
$211.68
 Law & Ethics $85.00 + 7% PST and 5% GST =
$95.20 (This $85 rate applies to those who have
paid to attend the Law & Ethics seminar.)
 Pick-up at APEGBC office
 Parcel Post (no charge)
 Express Courier: please add the following rates:
o - $40.00 + PST/GST within BC
o - $40.00 + PST/GST to other Canadian
o provinces
o - $50.00 + PST/GST to the United States
o - $100.00 + PST/GST outside North
America

Total Payment Enclosed (including GST/PST) $____________ Payment Must Accompany Form

Payment Method
Please Return Form To

 VISA / MasterCard / AMEX Professional Development Fax: 604-430-8085

APEGBC Tel: 604-430-8035
 Cheque payable to APEGBC 200 – 4010 Regent Street
Burnaby, BC V5C 6N2
Credit Card Information (if applicable*)
 *I will call with my credit card info.

Card Number __________ - ____________ - _____________ - _____________ Card Expiry Date _______/______

Cardholder Name Signature

DVD PURCHASE IS NON-REFUNDABLE