PEX Card Application & Agreement
All questions require answers
First and Last Name
Street Address, including City, State & Zip/Postal Code
Phone Number, Including Area Code
Your Date of Birth
Please use "mm/dd/yyyy" format. This information is required by our vendor and will not be shared
What Chapter(s) or Bridge(s) will you be making purchases for using the card?
Have you signed an agreement as a Chapter Leader in the past year?
How soon do you need the card?
Approval usually occurs within a day or two, but allow a week to be on the safe side. Select which shipping option you want. Fees are subtracted from your Chapter or Bridge balance.
Free: up to 3 weeks after approval
$35: up to 4 business days after approval
$45: up to 3 business days after approval
By applying for the PEX Card for my chapter, I agree that I will never share my card number and I agree to use the card issued to me by Bridge Foundry ONLY for approved expenses in support of the Bridge Foundry mission of increasing diversity in the development community. I also agree to submit scans of receipts to
within 5 days of the end of the month when the charge was incurred, and understand that failure to do so or misuse of funds may result in the revocation of PEX Card privileges.
Examples: Installfest refreshments/pizza, Breakfast/lunch, USB drives, Nametags, pens, stickers & misc supplies
I don't agree
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