recruiting new members!

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To become a member of PIC please submit your information using the form below. Becoming a member is FREE and will subscribe you to our email list, giving you access to all of our events, workshops, and resources.

Questions? Email [email protected].

Become a Philadelphia Immunization Coalition member!

potential members can sign up to be a member of the Philadelphia Immunization Coalition

Name(Last)

Name(First)

Work(Organization)

Job Title

Work Phone

Address

Are you representing an organization?

Yes

Are you and or your organization based in Philadelphia?

Yes, I live and work in Philly.

I work in Philly.

I live in Philly.

PIC primarily serves the Philadelphia County, but we are open to the possibility of collaborating, educating, and learning with individuals, and/or organizations with similar objectives to help with equitable healthcare in underserved communities.

Any immz coalition affiliation outside of the Philly County?

Yes

If yes to the above question, with whom are you affiliated?

How would you like to be involved with PIC?

Meetings? Stay in the PIC know!.

Volunteer/outreach?

Learning opportunities?

Fundraising?

Wherever I can best help!

All of the above!

Questions or anything else you'd like to share with us?

Thank you! We'll be in touch.

By submitting your email, you agree to receive 1-2 monthly emails from PIC. If you have any questions or would like to speak to someone from our team, please email us at [email protected].

Become a Vaccine Champion

Help Keep Philadelphia Safe from Vaccine Preventable Disease

Become a sustaining member of the Philadelphia Immunization Coalition today!

THE PHILADELPHIA IMMUNIZATION COALITION
1101 Market St., Fl. 12, Philadelphia, PA, 19107
[email protected]
www.facebook.com/phillyimmunize.org