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Counselor Role
*
I am a New Chapter Counsleor
I am a New Associate Counselor
I am resigning from a Counselor position (continue below)
Your Name
*
Prefix
*
First Name
*
Last Name
*
Email
*
Position
Chapter Greek Name or Number (i.e. Alpha Chapter, c1) if Known
Institution
*
Include campus or center location if applicable
New Counselor Name and Email
*
If unknown, list the Dean or Chair who will be in charge of identifying your replacement
Dean/Chair Name and Email
*
KDP sends a Counselor Commendation Letter to this person in the spring
Work Mailing Address (for official chapter mailings)
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands (US)
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces (the) Americas
Armed Forces Europe
Armed Forces Pacific
Army Post Office (U.S. Army and U.S. Air Force)
Fleet Post Office (U.S. Navy and U.S. Marine Corps)
State
ZIP Code
Preferred Phone
*
Are you now or have ever been a member of Kappa Delta Pi, International Honor Society in Education?
*
Yes
No
Unsure
If Yes (or unsure)
Have you previously served as KDP Chapter Counselor?
*
No
Yes, as a Counselor or Associate Counselor for this chapter
Yes, for another institution
Yes, in an informal role
Previous Chapter or Institution
Name and Email of Previous Counselor
*
Expected Start Date for Counselor Role
*
Or expected end date if resigning
Active Membership Options
*
I am already an active member of the society (ID# listed above)
Please send me information on how to pay my dues to be active with the Society
My chapter or school will pay my dues, please send an invoice
I will telephone 800-284-3167 and make the dues payment over the phone
Other:
Other Value
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