Request for Induction

In order to request a PDE-426 evaluation, please complete this form, click submit and then make payment ($300.00) to PAEYC.  Evaluations will be scheduled once payment is received.  You may make payment online or by mailing in a check. You must complete the request form for each evaluation needed. If you have questions, please contact Jan Sapotichne.

Inductee
Facility

If paying by check:
Fill out the form, click submit, and disregard the PayPal payment page.
Write a check made out to PAEYC, and mail to:
PAEYC
Attention: Induction
5604 Solway Street Pittsburgh, PA 15217


If paying by card:
You will be directed to PayPal once you click on Submit below.

Evaluations will be scheduled as requests are received.

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