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Forms and Publications

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Five Facts Flyer–Portable Document File (.pdf) format
This eight-panel flyer describes five facts about Paralyzed Veterans of America that you may not have known, and clarifies a couple of frequent misconceptions. Learn why PVA, the Keystone Chapter, and the other 32 chapters across the nation comprise a veterans service organization that is surprisingly influential for its size. Members and other supporters of PVA’s work for veterans can print this out or send it along by e-mail to others with whom you would like to share our message.

Membership Application–portable document file (.pdf) format
Use this form to apply for full, voting membership in Keystone PVA. A full, voting member is one with a documented spinal cord dysfunction and has been discharged honorably from the United States Armed Services. There is no fee to become a full member. Also you will need to have your doctor fill out this medical form click here and your DD-214.

Associate Membership Application–portable document file (.pdf) format
We’ll put this up soon. In the meantime, you can get one by calling the office. Associate membership is for anyone who wishes to be a member but, because he or she is not a veteran or is not affected by a spinal cord dysfunction, cannot be a full, voting member. The associate membership fee is $25 annually. Lifetime associate membership is available for a one-time fee of $250.00.

Keystone PVA Operations Manual –portable document file (.pdf) format
This is the chapter’s rule book. It’s 490KB in size in portable document file (.pdf) format, so it may take a minute to download if you use dial-up Internet service.

Prosthetics Delay Report Form –portable document file (.pdf) format
This for veterans to report delays more than 30 days in the delivery of prosthetic devices, such as wheelchairs, to the national PVA office. It’s 520KB in size in portable document file (.pdf) format, so it may take a minute to download if you use dial-up Internet service. The form gives you e-mail and fax information so you can return it; you can also mail it to  Paralyzed Veterans of America, 801 18th Street N.W., Washington DC 20006-3517. The form is fillable, that is, if you access it online, you can fill it out right on your computer.

Volunteer Program Report–MS Word format
Volunteer Program Report–Adobe portable document file format PDF file.
Use this form (your choice of format) to request reimbursement for qualified out-of-pocket expenses you have incurred while doing work on behalf of the Keystone PVA. If you are not sure if an expense is qualified, contact the chapter treasurer.

Volunteer Program Report–extra page–MS Word format
Volunteer Program Report–extra page–Adobe portable document file format
Use this form (your choice of format) if you need an extra page for your Volunteer Program Report

Sponsorship Funding Application–MS Word format
Sponsorship Funding Application–Adobe portable document file format
If you are a full member, you can use this form (your choice of format) to apply for chapter financial support of a qualifying recreational activity. But don’t send it in without consulting with a chapter officer. The Board always wants a heads-up before considering a new request.

SCI Annual Examination Survey–MS Word format
SCI Annual Examination Survey–Adobe portable document file format
Keystone PVA members should use this form (your choice of format) immediately following your annual SCI exam to provide important feedback on your experience. We will delete your name and the date and time of your visit and return it to the SCI coordinator at the facility at which you had your exam. You will receive two Health and Recreation Points toward your chapter recreational support eligibility by returning this form.

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