Chapter Application

Newsflash:

Chapter Application

Use this form to apply to start a new PDA Chapter

Required *

Chapter Name *

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Your Email Address *

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Chapter Leader * First and Last Name of Chapter Leader

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Phone Phone Number with Area Code

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EMail *

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Please enter the name and contact information for the 5 members who will assist you in starting your PDA chapter.

Each chapter must have a chapter leader. Strong chapters have at least two of the following roles:

Outreach Coordinator
Communications/Tech Coordinator
Event Coordinator
Fundraising Coordinator
Media Coordinator

Position *

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Member 2 Information

Name *

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Phone

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Email *

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Position *

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Member 3 Information

Name *

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Phone

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Email *

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Position *

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Member 4 Information

Name *

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Phone

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Email *

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Position *

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Member 5 Information

Name *

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Phone

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Email *

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Position *

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What area will your chapter service? *

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Does your chapter have a specific area of interest?

What contact information would you like publicly listed for your Chapter (contact name, phone, web address, and/or email)? (Please be sure the information is entered accurately.)*

Published Contact Information *

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How many members are currently in your chapter?

Members * Enter a number

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Have you already been holding meetings and/or events?

Chapter Meetings/Events * Yes No

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Would you like us to assist you with a Chapter Launch meeting?

Help from National Yes No

Are you and your members familiar with PDA's Issues and Positions on those Issues?

PDA Positions and Issues * Yes No

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PDA is a federal PAC; as such your chapter will be bound by FEC regulations. PDA national will file all reports and maintain the record of expenditures and income. By checking this box you agree to these terms.*

Do you agree to the terms listed above * Yes No

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