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-- Secure KANAAE Husband & Wife Application --
* This Field is required Required field | Information



Secure KANAAE Husband & Wife Application


After submitting the secure membership application below you will receive a confirmation page and receipt of your pending application. Your application will be processed immediately and your credit card will not be charged until your application is approved.

This page is for married members joining or renewing KANAAE professional membership at a special husband & wife discount rate.  For all other new members and renewals, please visit the KANAAE join page.

Membership Plan:  * This Field is required




 

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New Member or Renewal:  * This Field is required


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If you are only trying to update your contact or payment information, use the Update Form.

HUSBAND CONTACT INFO:
First Name:
Invalid Input * This Field is required
Middle Name: Invalid Input
Last Name:
Invalid Input * This Field is required
Preferred Email:
Invalid Input * This Field is required
Preferred Email Type:
Invalid Input * This Field is required
Alternate Email: Invalid Input
Phone Number:
Invalid Input * This Field is required    Invalid Input      format: xxx-xxx-xxxx
Alternate Phone Number: Invalid Input     Invalid Input      format: xxx-xxx-xxxx
Mailing Address:
Invalid Input * This Field is required
Mailing Address Apt/Suite: Invalid Input
City:
Invalid Input * This Field is required
State:
Invalid Input * This Field is required
Zip Code:
Invalid Input * This Field is required
Birth Date: Invalid InputInvalid InputInvalid Input * This Field is required
Monthly Newsletter: Invalid Input * This Field is required

HUSBAND SCHOOL INFO:
School Name: Invalid Input * This Field is required
School Type: Invalid Input * This Field is required      Other:
School District: Invalid Input * This Field is required include USD#
School County: Invalid Input * This Field is required
School State:
Kansas * Visit www.aaeteachers.org to join our national partner if you teach in a state other than Kansas.
Position: Invalid Input * This Field is required
Grades: Invalid Input * This Field is required
Subjects: Invalid Input * This Field is required

WIFE CONTACT INFO:
First Name:
Invalid Input * This Field is required
Middle Name: Invalid Input
Last Name:
Invalid Input * This Field is required
Preferred Email:
Invalid Input * This Field is required
Preferred Email Type:
Invalid Input * This Field is required
Alternate Email: Invalid Input
Phone Number:
Invalid Input * This Field is required    Invalid Input      format: xxx-xxx-xxxx
Alternate Phone Number: Invalid Input     Invalid Input      format: xxx-xxx-xxxx
Invalid Input * Check this box if mailing address is the the same for both members and skip down to 'Birth Date'
Mailing Address:
Invalid Input * This Field is required unless 'Same address as husband' is checked
Mailing Address Apt/Suite: Invalid Input
City:
Invalid Input * This Field is required unless 'Same address as husband' is checked
State:
Invalid Input * This Field is required unless 'Same address as husband' is checked
Zip Code:
Invalid Input * This Field is required unless 'Same address as husband' is checked
Birth Date: Invalid InputInvalid InputInvalid Input * This Field is required
Monthly Newsletter: Invalid Input * This Field is required

WIFE SCHOOL INFO:
School Name: Invalid Input * This Field is required
School Type: Invalid Input * This Field is required      Other:
School District: Invalid Input * This Field is required include USD#
School County: Invalid Input * This Field is required
School State:
Kansas * Visit www.aaeteachers.org to join our national partner if you teach in a state other than Kansas.
Position: Invalid Input * This Field is required
Grades: Invalid Input * This Field is required
Subjects: Invalid Input * This Field is required

PAYMENT INFO:
Card Type:
Invalid Input * This Field is required
Name on Card:
Invalid Input * This Field is required
Credit Card Number:
Invalid Input * This Field is required
Card Expiration Date:
Invalid InputInvalid Input * This Field is required

OTHER INFO:
Who referred you to or how
did you hear about KANAAE?
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First Year Teachers: Invalid Input
Interested in getting
more involved?

check all that apply





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