2025 Membership Renewal Form I am:A new PeDRA member, joining for the first time in 2025.An existing PeDRA member, renewing for 2025. Please select your membership category:Please select... Active Member ($125 until December 31st) Affiliate Member ($75 until Decembrer 31st) Emeritus Member ($50 until December 31st) Trainee Member (residents, fellows, and postdocs) - FREE Community Member (patients, parents, and advocates) - FREE Student Member (medical and graduate students) - FREE Please select your membership category:Please select... Active Member ($125 until December 31st) Affiliate Member ($75 until December 31st) Emeritus Member ($50 until December 31st) Trainee Member (residents, fellows, and postdocs) - FREE Community Member (patients, parents, and advocates) - FREE Student Member (medical and graduate students) - FREE First Name Last Name Email If possible, please use the one connected to your membership account. Are you a:ResidentClinical FellowPostdocOther - write in below Are you a:Medical StudentGraduate StudentOther - write in below Other position: In what year do you anticipate completing your highest level of training? In what year did you complete your training? Thank you for being a PeDRA Community Member and part of PeDRA's vibrant community of patients, parents, and advocates who prioritize pediatric dermatology research in 2025. We look forward to a wonderful year! Please renew my free PeDRA MembershipPlease cancel my membership In addition to paying your PeDRA Membership dues, would you like to make a donation to PeDRA to support its mission to create, inspire, and sustain research to prevent, treat, and cure childhood skin disease? YesNo, thank you. If you're interested in becoming a sustaining donor. Please go to https://pedraresearch.org/donate/ to complete the PeDRA recurring donation form and receive a PeDRA "Holding Up The Rock" t-shirt. x How often do you want to make this donation? One-timeEvery month for one yearMake a recurring donation of at least $10/month to receive a free PeDRA "holding up the rock" t-shirt. I would like to donate: $1,000 (Summit Society)$500 (Alpine Circle)$250 (Mountaineer)$100 (Climber)$50$10OtherPlease note that for recurring donations, this will be the amount of each monthly donation. Not the total. Other Donation Amount Please enter the amount in USD. Do not include any symbols (i.e. "$"). I would like to dedicate my donation to honor or remember: Comments: Do you have a discount code?YesNo Enter the discount code here: Discount Amount Payment Information Dollar Amount in USD Dollar Amount in USD Dollar Amount in USD Name on Card Card Number MM YY Code Authnet_Hidden_Fields Thank you for helping to hold up the PeDRA rock*! Please use the space below to provide the information we'll need to send you a t-shirt: T-shirt style: UnisexWomen'sBoth t-shirts are 100% fine jersey cotton and can be ordered in either Adult Unisex sizes S – 3XL or Women’s Fit sizes S – 2XL. The t-shirts, by Bella+Canvas, are one of the softest, smoothest shirts. It’s medium-weight and made from combed cotton for added comfort. Both t-shirt styles are a slim, flattering, and stylish fit. They do run small; order 1 size up if you prefer a looser fit. T-shirt sizeSMLXLXXLXXXL *If you'd prefer to receive the 2025 Holding Up the Rock t-shirt after January 1, 2025, instead of the 2024 t-shirt, please indicate below. Shipping Address Line 1 Shipping Address Line 2 City State or Province Postal Code CountryPlease select... 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Note: After clicking submit you may see a message appear that says "there was an error computing this field." This can be ignored. Please do not navigate away from the page until you see a confirmation message. Email us at info@pedraresearch.org if you encounter significant delays. Contact Information
