Membership Application Form
To become a member, or renew your membership, or add additional sites, please complete the following form. This information will be used in the Association's website and membership mailings. Those affiliated with a licensed Center must take a Center membership. Individuals and companies interested in adult day services who do not operate a licensed center are welcome to join as an Allied Professional. You may pay online at a secure web site by clicking on the apporpriate option below the form.
New provider member applicants, please submit a copy of your license and an agency brochure with a check made payable to PADSA. Please send both to:
Pennsylvania Adult Day Services Association
c/o Susan Nirschel
239 Hytyre Farms Drive
Gibsonia, PA 15044
Phone: (412) 281-7244, ext. 247
Fax: (412) 281-9333
www.padsa.org / E-Mail info@padsa.org
If you would like a hard copy of the form to fill out, please click here.
In order to view/print the Membership Application Form, you must have Adobe Acrobat Reader installed on your computer.

Adobe |