Annual Membership Enrollment Form

Welcome to KDPP. Please take a few moments and complete the form below. Once we receive the form, along with your payment for annual dues, we'll contact you to confirm your membership and notify you of upcoming events.

Member Information

Last Name
First Name
Middle Initial
Title	Dr. Mr. Ms. Mrs.
School District
Mailing Address
City
State
Zip
Position
Office Area Code/Phone
Office Fax
Office E-mail

Membership Type

Please indicate type membership by checking one of the following:

New Member (I'm joining KDPP for the first time.) -- $20.00

Renewal (Please renew my membership for the coming year.) -- $20.00

Retired Member -- $10.00

Payment Information

I have mailed a check for the membership type/amount indicated above.

Checks should be made payable to KDPP and mailed to the following:

KDPP

152 Consumer Lane

Frankfort, KY 40601

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Wayne Young, Executive Director
Rhonda Caldwell, Deputy Director
Clyde Caudill, Legislative Liaison
Shirley LaFavers, Director of Professional Development
Wanda Darland, Communications Specialist

152 Consumer Lane
Frankfort, KY 40601
(800) 928-KASA or
(502) 875-3411

Fax (502) 875-4634