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KENTUCKY EDUCATION ASSOCIATION

Uniting, Organizing, Empowering Members



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Fellows Program Application


Name:
Address:
City:
State:
Zip:
Home Phone:
Mobile Phone:
Personal Email:
Work Site Email:
 
School District:
Position:
Ethnicity:
KEA District:
 
Have you ever attended a national level conference of any kind?:
Yes
No
 
How long have you been involved in public education?:
 
Do you currently hold a leadership position of any kind in KEA?:
Yes
No
If so, please describe:
 
Do you belong to any other professional organizations?:
Yes
No
If so, please describe:
 
Have you ever been a participant in KEA Emerging Leadership Training?:
Yes
No
 
In 300 words or less, tell your story, and explain why you would like to be part of the KEA Fellows Program.
 
CONTRACT OF OBLIGATION

I agree to fully participate in the KEA FELLOWS program. I understand that am one of a limited group of members from across the Commonwealth who has been selected to participate in this year’s KEA Fellows class. I have a full understanding of the obligation of time and effort expected on my part.

I pledge to fulfill the following:
  • I will engage in all activities to the fullest of my abilities.

  • I will attend all functions and events unless an emergency arises or I am doing other work of the Association. I further understand that if I miss two consecutive events/actions, I will be removed from the program.

  • I will notify one of the mentors if I am unable to attend an event or function as soon as I am aware of my absence.

  • I will participate in email, conference calls and join the Fellows Facebook page.

  • I will support the Program making every effort to build relationships with other fellows and speaking for the program on my local and district level.
 
I understand that signing below constitutes a legal signature confirming that I acknowledge and agree to the above Contract of Obligation.