MEMBERSHIP APPLICATION FOR KENTUCKY ASSOCIATION OF TEACHER EDUCATORS

 

___ New Member $15

 

___ Active Membership $15

 

___ Remittance enclosed

___ Retired Membership $5

___ Renewal: July 1

___ Student Membership $5

 

Name:

_________________________________________________________________________

Mailing Address:

_________________________________________________________________________

City _____________________ State _____ ZIP________ Phone (____) __________

Institutional Affiliation:  ____________________________________________

E-MAIL _________________________________________________________________

 

The following information is important for our records:

___ Principal/Superintendent

___ Dean and Chair

___ Certification Officer

___Cooperating Teacher

___ Director of Student Teaching

___ Student

___ College Supervisor

___ College Teacher

___ Retired Educator

___ P-12 Teacher

 

 

PLEASE SUBMIT FORM TO:

Manish Sharma
Thomas More College
333 Thomas More Parkway
Crestview Hills, KY 41017


or manish.sharma@thomasmore.edu