Membership Application

Check below to see if payroll deduction is available for your district. If not listed, do not select payroll deduction as your membership type. AL-Chilton Public Schools AL-Elmore County Public Schools GA-Oconee County School District GA-Stephens County School District KY-Allen County School District KY-Burgin Independent KY-Crittenden County School District KY-Hardin County School District KY-Knox County Public Schools KY-Wayne County School District KY-Williamsburg Independent Schools Select your membership type Prefix Dr Miss Mr Mr & Mrs Mrs Ms Pastor Rev First Name Middle/Initial Last Name Suffix Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip - Zip Suffix Birth Date / / Gender Female Male School, College, or University Where You Work, or if a full-time student, your college/university name. Enter NA if this doesn't apply to you. Where did you receive your bachelor's degree? Enter without abbreviations. Enter NA if it doesn't apply to you. Estimated graduation date Home Address Home City Home State Home Zip Create a Login Name (Spaces are not allowed) Login Password (Your password requires at least 8 characters, including at least one number. Spaces are not allowed) Retype Password: Cell Phone (Enter 555 555-5555 if no cell) Home Phone (Please provide if you have one) Work Phone Primary Email Secondary Email District Position Teacher Media/Librarian Instructional Asst/Aide Principal Asst Principal Administrator Bus Driver Coach Consultant Counselor Nurse Support Personnel Dean Professor School Psychologist Secretary/Clerical Speech Pathologist Substitute Superintendent Asst Superintendent Retired Other Subject Taught Grade Level Church Name Prayer Group Delivery preference Mail my magazine Email my magazine Daily Devotionals Faith Agreement How did you hear about Christian Educators? Rise Up Summit AWAKE Church College/University Pray Like Monks Daniel Weekend Internet Search LIFT America Radio Referred by another organization Referred by a colleague/friend Social Media Teach 4 the Heart Teachers of Vision Magazine YouTube Other Please provide additional information or suggestions of additional ways we can be of service to you. Christian Educators will text renewal reminders and other important updates. By opting-in, you agree to receive these communications. You may opt-out at any time.