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Individual Membership Sign Up - PO
Name
(Required)
First
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Email
(Required)
School, District or Institution you represent
Role or Title (if applicable)
By submitting this form, you agree to the annual membership fee of $100. An invoice will be sent to your email address. The check / PO should be made out to "KEDC" (KREA's fiscal agent). "KREA Membership" will be itemized on the invoice and should be in the memo portion of the check. The address on the PO should be 904 Rose Road, Ashland, KY 41102.
