2008 KAE4-HA Membership Form

To be eligible to serve as a committee chair, run for office and/or apply for KAE4-HA Awards, 2008 dues must be received on or before the last day of  2007 annual conference.  Dues are payable to KAE4- HA. Mail a copy of this membership form and your dues check to Tyrone Gentry, 106 South Public Square, Greensburg, KY 42743. Dues are not considered paid until the check is postmarked and received by the association treasurer.

First Name:   Last Name: 
County: Area: District:  
Membership Type (select one):    Number of years as a member: 
Extension Title:
E-mail address:   
Office mailing address: 
Office City:          State:     Zip: 
Office Phone:       Fax:   
Have any of the following changed in the last year? Please check:  
                 Name          Office Address            Office Phone

Committee Preference -Please number your committee preference 1st, 2nd, or 3rd.
Public Relations and Information    Nominating (one member per area)
Professional Development Policy and Resolutions
Conference Planning Member Recognition
Benefits Programs (task force chairs are automatically members)  
Diversity Social
Budget Gifts
Legislative Relations Evaluation and Research   
Membership (area association directors are automatically members)

Are you willing to serve as a committee chairperson?                   
....as a chair-elect?         
 If so, which committee? 
You are encouraged to serve on a task force. You will have the opportunity to serve by selecting one at your next association meeting.

What can your association do to make your membership more valuable?

Final Instructions:

  1. Review all information to ensure accuracy.

  2. Print this form before clicking the "Submit" button for your records.

  3. Follow the mailing directions on the next page. 

  4. Click submit. 

 

Hit Counter