P.O. Box 1298 West Chester, PA 19380

Corporate Membership Form

Corporate Membership Applications

Click HERE to download a PDF of our membership application. Please email completed forms to pdetrade@comcast.net.


Corporate Membership Application

The following information is required to have the PDE Board of
Directors consider your application for membership in the PDE.
Company Name:
Address Line 1:
Address Line 2:
Zip Code:

Nature of Business:
  Pharmaceutical Manufacturer  Chemical Supplier  Allied Trade (Specify)
Type of Organization:
  Corporation  Private  Publicly Held  Division
Name of Parent Company:

Annual sales:
Annual sales to the drug industry:
Number of drug industry customers:
Number of employees:
Date Founded:

Company Information

Describe key product line(s) or service(s) provided:

Interest in the PDE

Please state why your company is interested in joining the PDE:

Company Representatives

Please give the following information for the persons who would represent your company with the PDE as:

Official Correspondent: (Primary contact)

Preferred Mail Address:
Zip Code:
Office Phone:
Cell Phone:
E-Mail Address:

$595 payable to “PDE” and will be billed after membership approval.