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Name:  
 
Male / Female

School:
 
HS     MS     Both     (circle one)      
 
School Address: 
 
City & Zip:

 
Email Address: 

 
Office Phone:
 
Office Fax:
  
HS Classification: 
 
1st time KIAAA member (circle one):    YES    NO                     
 
 
Please note the following:
 
·         KIAAA annual memberships are for the school calendar year, August 2008 - July 2009. 
     
 

Annual KIAAA Membership Dues:   $25.00