Embarking on a journey to join the Texas Association for Health, Physical Education, Recreation, & Dance (TAHPERD) begins with a detailed membership application form, designed to cater to a diverse group of professionals and students within the health and education sector. Located at 7910 Cameron Road in Austin, Texas, TAHPERD opens its doors wide to prospective members, offering various categories of membership to suit different professional statuses and interests. The membership application not only seeks basic personal information such as name, contact details, and home mailing address but delves deeper into professional specifics. Applicants are asked to outline their primary job description, secondary interests, and highest degree completed, providing a comprehensive view of their professional background and interests within the fields of health, physical education, recreation, and dance. The form is meticulously structured to gather information for grant purposes, including ethnicity, gender, and birth year, while also offering spaces for members to affirm their previous affiliations with TAHPERD and their certifications. Furthermore, the form facilitates a selection between different membership options, ranging from a one-year professional membership to student and retired memberships, alongside payment instructions to ensure a smooth application process. This essential document, available for download or direct submission, serves as the gateway for professionals aiming to enrich their careers and networks within these specialized fields, emphasizing TAHPERD's dedication to fostering a community of passionate individuals committed to advancing health and education.
| Question | Answer |
|---|---|
| Form Name | Tahperd Membership Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | tapherd membership form, SHAC, attendee, Newsletters |
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MEMBERSHIP APPLICATION |
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7910 Cameron Road | Austin, Texas 78754 |
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Ph: (512) |
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Name: |
Work Phone Number: |
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ISD/University/Other Employer: |
Home Phone Number: |
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Campus/School Name: |
Cell Phone Number: |
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Home Mailing Address: |
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City/State/Zip: |
Ethnicity: (For Grant Purposes) |
Gender: (For Grant Purposes) |
If a Previous TAHPERD Member: |
Birth Year: (For Grant Purposes) |
Teacher Certification Year: |
Member ID#: |
Expiration Date: |
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PROFESSIONAL MEMBERS ONLY
INSTRUCTIONS:Pleaseusethecorrespondingnumbersinthecolumnsbelowtoselectthebestdescriptionineachcategory.
PRIMARY Job Description: |
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SECONDARYInterest: |
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Classification: |
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Highest Degree Completed: |
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Primary Interest: |
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PRIMARY Job Description: |
Classification: |
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PRIMARY Interest: |
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(choose one) |
(choose one) |
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(choose one) |
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1. |
Teacher/Professor |
1. Elementary |
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Physical Education |
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2. |
AthleticCoach |
2. Middle School |
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2. |
Athletics |
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3. |
AthleticTrainer/SportsMedicine |
3. Secondary |
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3. |
Research |
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4. |
Administrator |
4. Community/Junior College |
4. |
Dance |
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5. |
Teacher’s Aide |
5. College/University |
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5. |
Recreation |
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6. |
Recreation/Parks Staff |
6. Government Office/Agency |
6. |
Health |
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7. |
Hospital/Clinic Staff |
7. Recreation/Parks |
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7. |
Adapted/Special Programs |
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8. |
Private/VolunteerAgency |
8. Other |
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8. |
Administration |
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9. |
Corporate/Private Fitness |
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9. |
Other |
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10. Other |
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SECONDARY Interest: |
Please Check the Boxes that Apply: |
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(choose one) |
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1. |
Physical Education |
My school has a School Health Advisory Council (SHAC) |
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2. |
Athletics |
My SHAC meets on a regular basis |
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3. |
Research |
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I coordinate a Hoops for Heart event |
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4. |
Dance |
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I coordinate a Jump Rope for Heart event |
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5. |
Recreation |
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6. |
Health |
I am a Physical Education Coordinator or similar |
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7. |
Adapted/Special Programs |
Administrator |
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8. |
Administration |
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I am a college majors club sponsor |
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9. |
Other |
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Highest Degree
Completed:
1.Bachelors
2.Masters
3.Doctorate
MEMBERSHIP OPTIONS (CHECK ONE) |
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❏Professional Membership (One Year) |
$ 60 |
(Certified Teachers and Professionals) |
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❏5 yr. Professional Membership |
$ 261 |
❏AssociateMembership |
$ 50 |
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$ 60 |
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❏Student Membership |
$ 20 |
(Student MUST be a |
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❏Retired Membership |
$ 20 |
(Contact TAHPERD State Office for eligibility criteria.) |
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Payment Information
Check enclosed payable to: TAHPERD
Credit Card#: ____________________ Exp. Date:_____
Signature:__________________________________
If Paying with a School Purchase Order
Please Read the Following:
Individual application forms for each attendee must be attached to all school purchase orders. All checks sent to the State Office by a school district must attach copies of eachattendee’s application form.
Original/CopyoforiginalPORequired.
RequisitionortravelvouchersforP.O.’sareNOTaccepteddocumentation.
BillingAddressMUSTbeonthepurchaseorder.
FOR TAHPERD OFFICE USE ONLY:
CC AP#______________________ PO # ____________________