Chapter interest survey

 

Chapter interest survey

  Contact info

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Name:

 

 

   

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City/State/ZIP:

 

    

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If you respond and have not already registered, you will receive periodic updates and communications from PKD Foundation.


 


 


 
Question - Not Required - How are you interested in participating with your local Chapter? (Check all that apply)

 

While each one of our local 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)

 
Question - Not Required - Education





 
Question - Not Required - Support





 
Question - Not Required - Awareness





 
Question - Not Required - Fundraising





 
Question - Not Required - Advocacy





 
Question - Not Required - Please help us in planning future programs in your area by indicating topics that would interest you. (Check all that apply)

 


 

 

   Please leave this field empty