Welcome New User

Phone
This field is for validation purposes and should be left unchanged.
Name:*
Enter the first and last name of the individual for whom this account is being requested.
First Name (given name) Last Name
Preferred First Name / Nickname:*
Enter the preferred 'first name' or 'nickname' of the individual for whom this account is being requested. This is the name that will appear on printed materials, such as name badges or sign-in sheets, when attending an in-person training event or conference. NOTE: If a nickname is not preferred, please type the individual's 'first name' into this field.
Email Address:*
Enter a valid email address for whom the account is being requested. An agency-issued email address is required to obtain an account under an existing organization/agency. Use of a personal email address requires approval/authorization from your agency's leadership.
Enter Email Confirm Email
Date of Birth:*
Select your birth 'month' and birth 'day' from the drop-down fields below. We are NOT requesting your birth 'year'. This information will be kept confidential and will only be used to flag accounts with the same 'First' name and 'Date of Birth', to assist us in identifying duplicate accounts.
Month
Day
Year
Organization Name:*
Select your organization's name from the drop-down list below. If the name of your organization does not appear in the list, please have the organization owner, president, CEO, or appropriate senior management personnel complete and submit a request to establish a PDA LMS 'organizational' account using the 'Register' link located on the PDA LMS site's home page.
Phone Number:*
Provide the best telephone number for our help center staff to reach you. Either the organization's main number or your direct number/extension.
Job Title/Position:*
Enter your job title/position name below.
Job Title Category:*
Select the category from the drop-down list below that closest matches your job title/position, regardless if you’re a staff, supervisor, or volunteer (if more than one category applies, choose the ‘primary’ category).
Other Job Category:
Training Categories:*
Place a check mark in the box next to each training category to which you would like access:
- AccuFund
- Assessments
- Caregiver Support Program (CSP)
- Diversity Training
- GENERAL
- Health & Wellness
- Housing Resources
- HSIM Training
- HSOA Training
- LTC Ombudsman
- Nutrition
- Older Adult Daily Living Center (RESTRICTED ACCESS - PDA-approval required)
- OPTIONS Program
- PA Link
- PA MEDI (RESTRICTED ACCESS - PDA-approval required)
- Protective Services (PS)
- SAMS and Mobile Assessments
- Senior Community Centers (SCC)
- Volunteer Coordinators
If requesting access to the OADLC/ADC Director Training:
For approval to access/complete the Older Adult Daily Living Center (OADLC)/ADC Director Online Training Course, provide the facility 'NAME' and 'COUNTY' of the Pennsylvania-licensed* Adult Day Center (ADC) providing adult day services.
*NOTE: If the center is not yet a PDA-licensed Adult Day Center (ADC) facility DO NOT SUBMIT THIS FORM! Please visit PDA's Adult Day Center (ADC) Licensing page to learn about Pennsylvania Adult Day Center licensing, registration, and how to access the online OADLC/ADC Director Online Training Course.
Are you completing this form on behalf of another individual?*
If YES, please provide your information in the fields below:
- NO
- YES
If you are completing this form on behalf of another individual, please provide YOUR name and email address below:
First Last Email Address
Notes:
Please provide additional information below that you feel may help clarify your request for PDA LMS technical assistance.

PDA LMS 'USER' TRAINING ACCOUNT REGISTRATION FORM:

Be sure to click the 'Submit Form' button located in the bottom-left corner of the form below when finished completing the form.