Join

Please fill out the form below to join us and to receive the emails.

Your Name (required):

Your Email (required):

Phone Number:

Street:

Street 2:

City:

State:

Zip:

Home Phone Number:

May we e-mail you occasionally with informative news?

Spouse Name:

Spouse Phone Number:

Spouse Email:


Children

The following information about your children will help us to better serve you.

NOTE: As a matter of policy your information is confidential which means we do NOT share any information with outside entities.

Please enter each child on a separate line:
(Child's Name, School Name, Grade)


Do you wish to volunteer for PCLDA projects?

Please let us know your interests: