CONSTITUENT ORGANIZATION DATA USAGE AGREEMENT AND REQUEST FORM
 
 

AAPA Constituent Organizations (COs) may request a complimentary list of either PAs and/or PA students two (2) times per calendar year for legislative and regulatory activities. These two lists are free.

In addition, COs may make a list request up to four (4) times per calendar year to use for membership, CME or advocacy activities. A $50 list rental fee will be assessed for each of these lists.

In lieu of paying the $50 list rental fee, COs may opt to provide AAPA with the CO’s membership list, containing USPS mailing address, phone number and email address and provided in standard ASCII, comma-delimited text format (first row contains column/field names). The CO’s membership list will be for single-use only and will not be incorporated into AAPA’s database. If a CO is purchasing more than one list at a time, the $50 fee will be waived for one list only. The CO membership list must be provided prior to processing the CO’s list rental request.

Please allow up to 10 business days for delivery of the list.

The guidelines provided and linked in this form replace any previous mailing list distribution policies and allow COs expanded outreach capabilities through access to AAPA's masterfile of email and USPS addresses.  Complimentary advocacy e-blasts may still be sent via AAPA's Advocacy Action Center.  Contact coadministrator@aapa.org to be referred to the appropriate State Advocacy and Outreach (SOA) staff member who will work with you to develop your advocacy message.

*The Data Usage Agreement outlines parameters for usage of the list and must be accepted upon each request. PLEASE READ THE DATA USAGE AGREEMENT. Please print, sign, and return the agreement by email to COAdministrator@aapa.org or fax to 703-684-1924. List Rental requests will not be processed until the signed agreement is received.

Response Required: *
*Acceptance of the terms of the agreement and authorization are required to process this request.

Design and Distribution Resources:  The CO is responsible for developing, formatting and distributing their own content. If you require technical assistance for design or distribution, please see the list of available vendors.  

Best Practice Guidelines for Communications:  COs are strongly encouraged to follow best practices when emailing members.  Following best practice guidelines will increase email open rates and help to avoid legal pitfalls.

List Delivery and Formatting:  Please allow two weeks for delivery of the list to the email address provided under Contact information.  The list will be provided in standard ASCII, comma-delimited text format (first row contains column/field names). The list will contain USPS mailing address, phone number and email address, to the extent they exist in the AAPA database. Individuals who have chosen not to have their information shared will not be included on the list.  State lists are generated based on individual's primary address on record.

The list will be encrypted and delivered with instructions to download free software to access and open the enclosed data. The software is PC compatible only and cannot be used on an Apple product. If you are using a work computer, you may need to secure administrator rights to install the software.

Each list request may include up to:

- Four (4) states (you may include your own state as one of the four, if desired); or

- Four (4) specialties (you may include your own organization's specialty as one of the four, if desired); or

- Five (5) federal service chapters

 

CONTACT INFORMATION

List will be used for the following purpose: *
Category: *
Select up to 4 states, including your own:
OR
Select up to 4 specialties, including your own:
OR
Select up to 5 federal service chapters:
PAYMENT INFORMATION
 
For assistance, please contact the CO Administrator or call 571-319-4366.