Application for Membership in Kinesiology Club (K-Club) AND MOAHPERT

Not complete until payment is received

Membership Dues Student Faculty
Total $30.00 $40.00
Make checks payable to: K-Club $15 for Local club Dues +
$15 for MOAHPERD Dues +
Includes a K-Club shirt
$5 for Local club Dues +
$35 for MOAHPERD Dues

National AAHPERT Dues (optional) $50 $135
Make checks payable to AAHPERD

Application to K-Club
Name:
 
Gender:
Year in school:
Major:
Phone:
 
Voice Mailbox:
 
Email Address:
 
School Address:
 
City:
 
State:
Zip Code:
 
Permanent Address:
 
City:
 
State:
Zip Code:
 
Interested in becoming more involved in K-Club by serving as an officer?
Suggestions for K-Club programs and activities:
 

Application to MOAHPERD (Mo Association of Health, Physical Education, Recreation and Dance)
Name:
 
Phone:
 
Email Address:
 
Permanent Address:
 
City:
 
State:
Zip Code:
 
County in which you live:
 

District: Southwest

Code: G

Membership Status:
AAHOERD member:
Check appropriate category:
Major/Interest Area:
Not completed until payment is submitted in the Kinesiology Department: