Kappa Delta Pi (KDP) International Honor Society in Education Professional Membership Application Thank you for your interest in membership. Please complete the following application digitally and send it to KDP Headquarters. You can expect to hear back from us within 7-10 business days following receipt of your application. NOTE: All fields must be completed to process your application. Member Information Name: Nickname: Birthdate: School/Organization Name: Title: Last Degree Earned: BS/BA Master’s Work Address: City: State/Province: Zip Code: Work phone: City: State/Province: Zip Code: I prefer to use Graduation Date: Country: Work Email: Home Address: Home Phone: Doctorate Cell Phone: Work Country: Personal Email: Home as my primary contact information. Membership Options NOTE: If you have previously been a member of Kappa Delta Pi, no additional documentation needs to be provided. Please contact KDP Headquarters (1-800-284-3167) to renew your membership. There is a one-time $1.00 application fee for members. (please select one) Membership Type Undergraduate Student Graduate Student Doctoral Student Student seeking alternative certification / licensure Qualifications Documentation Required Transcript No KDP chapter on campus; and Minimum cumulative GPA of 3.00; and 30 credit hours earned with 12 hours scheduled/in-progress in Education No KDP chapter on campus; and Evidence of completed Minimum cumulative GPA of 3.25; and BS/BA degree, BS/BA degree with minimum 3.0 GPA; or OR 12 credit hours completed/in-progress Transcript toward a Master’s degree with at least 6 credit hours earned at the same institution In a Doctoral program Evidence of work toward Doctoral degree Hold BS/BA degree; and Evidence of BS/BA degree At least 12 semester hours of alternative Transcript certification program completed; and Minimum cumulative GPA of 3.25 Cost $46 - 1 year $81 - 2 years $750 - Lifetime $46 - 1 year $81 - 2 years $750 - Lifetime $46 - 1 year $81 - 2 years $750 - Lifetime $46 - 1 year $81 - 2 years $750 - Lifetime (for more membership options, please see the next page) (please select one) Membership Type Qualifications Minimum cumulative GPA of 3.25; or Hold a Master’s or other advanced degree; or Ability to obtain two letters of recommendation Practicing Educator (please select one) Cost $46 - 1 year $81 - 2 years $750 - Lifetime Early Childhood Teacher Elementary Teacher Counselor Middle School Teacher Library/Media Specialist Substitute Teacher High School Teacher Professor/Faculty Member In an administrative position Administrator (please select one) Documentation Required Transcript, OR Two letters of recommendation from supervisors Evidence of position (e.g. business card) K–12 Administrator Superintendent/Principal Dean Higher Education Administrator $46 - 1 year $81 - 2 years $750 - Lifetime Proof of age; OR $25 - 1 year Evidence of $50 - 2 years retirement Please select your membership length: 1 year 2 years Lifetime Lifetime membership dues can be paid in 3 installments of $250 annually. Please check this box if you would like to pay in three installments. Retiree 55 years of age; or Have been retired for one year or longer Additional Publication Options Professional Members receive a complimentary one-year subscription to The KDP Record except for undergraduate student members who receive a one-year subscription to the New Teacher Advocate. Please select any additional publications that you would like to receive. New Teacher Advocate (Print & Digital) $12 for One Year $20 for Two Years New Teacher Advocate (Digital only) $10 for One Year $16 for Two Years The Educational Forum $25 for One Year $45 for Two Years Support Kappa Delta Pi All members are encouraged to give $19.11 annually in celebration of our founding year, 1911. Kappa Delta Pi is a registered 501(c)(3) organization; your contributions are tax-deductible and support a variety of programs and services. Be sure to include your donation in the total amount due on the next page. Yes! I would like to give a donation via this form in the amount of $19.11. Yes! I would like to give a donation via this form in the amount of $ . No, not at this time. Contact Preferences KDP provides an online Membership Directory through a members-only portal that allows information such as phone, email, and city/state location (not street address) to be searched and viewed by members. Check the following box if you do NOT want your information to be included in the Membership Directory. KDP occasionally makes its members’ contact information available to affiliated third party vendors who provide products and services to the education community. Check the following box if you do NOT want your information included on these lists. Payment Information (in US Dollars) Total Amount to be Paid: $ Check enclosed (payable to Kappa Delta Pi) Charge the above amount to my: American Express Account Number: Visa MasterCard Discover Expiration Date: Cardholder Name: SIGNATURE: _____________________________________________ NOTE: Your application cannot be accepted without a signature. Credit Card Auto-Renewal NEW! By enrolling in credit card auto-renewal, you agree to allow KDP to automatically charge future annual membership dues to your credit card up to 30 days prior to the expiration of your membership. Authorization to charge your card will remain in effect unless you notify KDP otherwise. Charges will reflect dues rate at the time of renewal. I agree to the terms and conditions of this payment agreement. At any time, I understand that the terms of this payment agreement may be changed and that I will be bound by the charges until I terminate my enrollment of this automated payment program. I agree to review the terms and conditions frequently to ensure that I understand and agree with all changes. I agree. Enroll me in Credit Card Auto-Renewal for membership payments. Submit Your Application Send your application to KDP Headquarters via the postal service with payment. Kappa Delta Pi, International Honor Society in Education c/o Membership Department 3707 Woodview Trace Indianapolis, IN 46268 If you have any questions, please contact our Membership Department at 1-800-284-3167 or email membership@kdp.org.