SHAPE Iowa Membership

SHAPE Iowa - Membership Registration

Please fill in the information below to become a member of SHAPE Iowa.

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address (non school email) *

Secondary Email *

Professional Social Media Handle(s)

Do you follow SHAPE Iowa on social media? *

Yes

No

Please select your level. *

Student

Professional

Retired

Students - College/University that you are attending

If you are a student, please indicate your anticipated semester and year of graduation: *

Professionals - Please select your teaching level.

AEA Region

Professionals - School District you are affiliated with. (Adair- Casey to Prairie Valley Community School Districts)

Professionals - School District you are affiliated with. (Red Oak to Woodward-Granger Community Schools)

If your school or institution are not listed in the drop down menus, please indicate your location: *

What do you teach?

Thank you for becoming involved in your professional organization, what are some things you hope to gain through your membership with us? *

Please only select "First Year Membership" if this is your FIRST YEAR of being a member as a student OR as a professional.

Membership Type *

Current Total:

$0.00

Required *

I have made sure that all information is current and correct.

If your school or institution are not found in the drop down menus, please state it here: *

Elementary	Middle School	High School	K-12
College/University	Community Agency	Other

Physical Education	Health	Adaptive Physical Education
College Level	Other