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Jacksonville State University

Chapter #0211


Application for Membership in PDK 

Jacksonville State University Chapter #0211 

Help your chapter grow by sponsoring a colleague!

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 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.

 

Sponsor: PDK Member ID:
:

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
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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


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