KC Kappa Dues Form

Notes: Deadline is May 31st to be listed in and receive "Blue Book" membership directory General Information
Kappa ($40) Key Kappa ($50) Golden Key Kappa ($75)
First Name:	Last Name:
Husband:	Maiden Name:
Contact Information
Street Address:	Home Phone: (xxx-xxx-xxxx)
City:	Work Phone: (xxx-xxx-xxxx)
State:	Cell Phone: (xxx-xxx-xxxx)
Zip:	E-mail:
	I would like to receive the Krier via E-mail ONLY Please do not include me in any E-mail correspondence
Kappa Information	Company Information
School:	Employer:
Chapter:	Product or Service:
Initiation Year:	Position:
	Please include me in the Networking section of the membership directory
Participation Options
	HOLIDAY HOMES TOUR (December 6 & 7, 2011)
NEW! Host a Summer Neighborhood Meeting Hospitality Party Committee (welcome new KC Kappas) Founders' Day Committee Winter Actives Party Committee (Actives & Mothers) Kappa Night Owls (Evening Activities) Kappa Book Club Kappas Helping Kappas (Meals, Flowers, Cheer) Host an Association Meeting Reading Is Fundamental “Signature Event” Committee Winter Association Party Committee	Sponsorhip or Underwriting Leads Tour Proceeds Committee (2012) Other Volunteer Inquiries Hostess Day Night Both Shop Personnel Day Evening Both Bakers (Recipes will be provided) Breads Pound Cake Fudge Cookies/Bars

Kappa Kappa Gamma Association Dues Form courtesy of Brian Ebbitts www.brianfe.com