rofessional membership is available to persons
who demonstrate professional conduct and who hold a baccalaureate degree, are
licensed or credentialed as educators, are employed in an education-related
field, or are undergraduate education majors who are participating in or have
completed student teaching. The purpose of Phi Delta Kappa International is to
promote quality education, in particular publicly supported education, as
essential to the development and maintenance of a democratic way of life.
As Kappans, we have the privilege and the obligation to nominate colleagues.
Your name and member ID number are needed to record and recognize those Kappans
who sponsor candidates for membership. Professional membership is available to
persons who demonstrate professional conduct and who hold a baccalaureate
degree, are licensed or credentialed as educators, are employed in an education
related field, or are undergraduate education majors who are participating in or
have completed student teaching. The purpose of Phi Delta Kappa International is
to promote quality education, in particular publicly supported education, as
essential to the maintenance of a democratic way of life. Completing this
application indicates your support of this purpose.
:
Please fill in the form completely.
Candidate
Last Name:
First Name:
Middle Name or Initial:
Preferred First Name
Address:
Address2
City:
State/Province:
Zip/Postal Code:
Home Phone
Country:
Home Phone/ Area Code:
E-mail Address
Employer no acronyms please
Employer address
Employer city
Employer State
Employer's Zip/Postal Code:
Work
Phone
Work
Fax
About You
Position
Birthday
Education
Gender MaleFemale
Fees
PDK International Dues $70.00
Processing Fee $5.00
Chapter Dues $10.00
Total Fees $85.00
Please make your check payable to
Phi Delta Kappa Chapter #0211
Please print out the page that appears after the
submission of this on-line document and mail it along with your fees to
Dr. Stanley Easton,
PDK Chapter #0211 Treasurer
1104 Church Avenue NE
Jacksonville, AL 36265