Chapter Interest Survey

Chapter Interest Survey
Questions that require an answer are marked with  *
   
1 Please choose your local Volunteer Chapter from the drop down below.
   
   
2 How long have you been involved with your local Volunteer Chapter?
   
   
3 How are you interested in participating with the local Chapter? Choose all that apply.
   






   
4 While each one of our local Volunteer Chapters is unique, they all support the PKD Foundation and are run entirely by volunteers. Please rank the following programs in the order of importance to you. (5= most important and 1= least important)
   
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Education
Support
Awareness
Fundraising
Advocacy
   
5 Please help us in planning future programs in your area by indicating topics that would interest you. Check all that apply.
   









   
6 Do you participate in any other programs of education or support in your local community that are not provided by the PKD Foundation?
   
   
7 Briefly describe programs of education or support offered locally and tell us how they are beneficial to you.
   
   
8 If you are interested in learning more about your local Volunteer Chapter or would like to volunteer, please provide your contact information. Thank you!
   
 Name
 Phone Number
 Email Address
   
9 Please provide any additional information about programs that you would like to have available to PKD patients in your area.
   
     

Your Organization

2000 Daniel Island Drive, Charleston SC 29492
Phone: 800.443.9441 | Fax: 843.216.6100
info@yourdomain.org

©2014, PKD Foundation ·The PKD Foundation is a 501 (c)(3), 509 (a)(1) public charity.

©2014, PKD Foundation ·The PKD Foundation is a 501 (c)(3), 509 (a)(1) public charity.

The PKD Foundation is a 501 (c)(3), 509 (a)(1) public charity.
National Headquarters: 8330 Ward Parkway, Suite 510, Kansas City, MO 64114. Phone: 1.800.PKD.CURE
©2014 PKD Foundation. Privacy Policy | Terms & Conditions

Founded in 1982, our vision is that one day,
no one will suffer the full effects of polycystic kidney disease.


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