Additional Information

FREQUENTLY ASKED QUESTIONS

OUR CHAPTER

Philadelphia CHADD Membership Support Application

Philadelphia CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) is excited to offer funding for one-year family memberships to CHADD for families experiencing economic hardships and unable to afford membership fees. This membership support funding is made available through a one-time, limited grant from the CHOP Care Community grant program. Support is based on self-reported financial need.  A one-year membership will be made available to those who qualify.  Membership support will be awarded on a rolling basis until funding is no longer available. Awardees are encouraged to attend Philadelphia CHADD meetings held on the third Thursday of each month at 6 p.m. at CHOP’s Karabots Center, 48th and Market Streets.

 

For more information or to learn about CHADD, please www.chadd.org.

 

Please use the application below to apply. Your physician/health care provider may also submit the application on your behalf.

Return application by emailing it to philadelphia-chadd@chadd.net or mailing it to Philadelphia CHADD, P.O. Box 20600, 2031 66th Avenue, Philadelphia, PA 19138

  (Please print neatly or type)

  Applicant’s Name: ______________________________________Daytime Phone: ____________________

 

Applicant’s Mailing Address: _________________________________________________________________

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How did you hear about this opportunity? ______________________________________________________

 

Applicant’s E-Mail Address: __________________________

 

Is the applicant a current member of CHADD? (please circle)   yes   no

             (If yes, when does the current membership expire? ________________________)

 

Financial Need

Briefly describe the financial hardship and how the person or family may benefit from a CHADD membership (use additional paper if needed).

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Person Completing Application: ___________________________Email Address: _______________________

 

Signature of Applicant: ____________________________________________ Date: ____________________

CHADD AFFILIATE: Philadelphia CHADD

Contact: Rhashidah Perry-Jones Philadelphia-CHADD@chadd.net;  Email: philadelphia-chadd@chadd.net;  Phone: (215) 948-2373

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CHADD AFFILIATE: Philadelphia CHADD

CHADD National

4221 Forbes Blvd, Suite 270
Lanham, MD 20706

Email: customer_service@chadd.org
Tel: 301-306-7070
Fax: 301-306-7090

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Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
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