Get Alpha Delta Kappa Application 2014-2025

Your subscriptions to our magazine the KAPPAN will also begin. Please send one check for total due payable to Alpha Delta Kappa. FEE FEES PAID One-Time Membership Application Fee Required nonrefundable 25. POSTAGE HANDLING CHART 1-2 badges. 4 Total 6 or more badges. 6 Total TOTAL Annual International dues will be payable in January of the calendar year following your initiation. NAME OF MEMBER SPONSORING NEW MEMBER State and Chapter Badges are shipped to chapter membership chairman. Telephone Current date MO/DAY/YR Anticipated date of initiation MO/DAY/YR SEND TO INTERNATIONAL HEADQUARTERS Alpha Delta Kappa 1615 W. 92nd St. Kansas City Missouri 64114-3210 816 363-5525 800 247-2311 Additional forms may be printed from the Alpha Delta Kappa International website at www. alphadeltakappa.org. Please do not fill out a jewelry order form for your membership badge. THIS APPLICATION WILL AUTOMATICALLY ORDER THE BADGE.. 00 Postage if more than one application is sent together include postage with only one application using the chart below. POSTAGE HANDLING CHART 1-2 badges. 4 Total 6 or more badges. 6 Total TOTAL Annual International dues will be payable in January of the calendar year following your initiation. NAME OF MEMBER SPONSORING NEW MEMBER State and Chapter Badges are shipped to chapter membership chairman. Telephone Current date MO/DAY/YR Anticipated date of initiation MO/DAY/YR SEND TO INTERNATIONAL HEADQUARTERS Alpha Delta Kappa 1615 W. 92nd St. Kansas City Missouri 64114-3210 816 363-5525 800 247-2311 Additional forms may be printed from the Alpha Delta Kappa International website at www. 3. Chapter membership chairman sends form with fees to International Headquarters prior to initiation. 4. Send Report of Initiation Form H-133 to Headquarters immediately after initiation. ALPHA DELTA KAPPA International Honorary Organization for Women Educators MEMBERSHIP APPLICATION State Chapter Name Applicants MUST be under contract in education to qualify for membership. Full Name First Middle Last Preferred Name Date of Birth Address City MO/DAY/YR Zip Place of Employment Business Phone Number Business E-Mail Home Phone Number Home E-mail ENTIRE SECTION MUST BE COMPLETED PLEASE CHECK ONLY ONE BOX IN EACH LINE Is currently under contract in education Yes No Has been in the education profession two full years or more Yes No Professional/Job Title Position 1 Teacher 2 Administrator Level 4 Elementary 5 Secondary Degree s in Education Received Bachelor s 3 Other 6 College/University Master s Doctorate Certification Yes No MEMBERSHIP ETHICS I submit this application with the knowledge that Alpha Delta Kappa membership is an honor. Send Report of Initiation Form H-133 to Headquarters immediately after initiation. ALPHA DELTA KAPPA International Honorary Organization for Women Educators MEMBERSHIP APPLICATION State Chapter Name Applicants MUST be under contract in education to qualify for membership. Full Name First Middle Last Preferred Name Date of Birth Address City MO/DAY/YR Zip Place of Employment Business Phone Number Business E-Mail Home Phone Number Home E-mail ENTIRE SECTION MUST BE COMPLETED PLEASE CHECK ONLY ONE BOX IN EACH LINE Is currently under contract in education Yes No Has been in the education profession two full years or more Yes No Professional/Job Title Position 1 Teacher 2 Administrator Level 4 Elementary 5 Secondary Degree s in Education Received Bachelor s 3 Other 6 College/University Master s Doctorate Certification Yes No MEMBERSHIP ETHICS I submit this application with the knowledge that Alpha Delta Kappa membership is an honor. I will accept the responsibilities and obligations of membership and regularly attend all meetings. .