*Your Name as you would like it to appear on your certificate:
*Your WALDEN e-Mail address:
*Your Walden ID:
Educational Level*: ---Undergraduate Student
Your current position*: ---Early Childhood TeacherElementary TeacherMiddle School TeacherHigh School TeacherPre-K through 12 AdministratorSuperintendent/PrincipalProfessor/Faculty MemberDeanHigher Ed AdministratorRetireeSubstitute TeacherOtherCounselorLibrary or Media SpecialistSecondary Teacher If other was chosen, please specify:
Your Specialty: ---Art EducationBusinessComputer ScienceEnglish/Language ArtsFamily & Consumer ScienceForeign LanguageGeneralistGifted/TalentedMathematicsMusic EducationHealth & Physical EducationReadingScienceSocial StudiesSpecial EducationOtherTeacher PreparationMedia/TechnologyCurriculum & Instruction If other was chosen, please specify:
(this should be the actual or anticipated date as related to your education level)
Yes, I give permission to transfer my membership from my old chapter to the AEX Chapter of KDP. I understand that I need to contact the national KDP office and notify them of my desire to have my membership transferred to the AEX Chapter.
If transferring, University/College where you joined KDP:
If transferred, month and year of your initiation:
Please provide your full mailing address.
*Street Address Line 1:
Street Address Line 2:
*What professional development activities are you willing to assist with in support of all members of the AEX Chapter of Kappa Delta Pi at Walden University? (newsletter, professional development journal, mentor, regional activities, local activities, online activities, website support, webinar development, etc.)
*Please provide as much of your Curriculum Vitae or Resume...Education related work experience only, and type your Walden University coursework, grades, and GPA here as well as your Education and Major Credit Courses here at Walden University. Please only list your GPA from Walden University...(A 3.00 GPA or higher with 30 or more completed credits is required to qualify for this Honor Society).
*Please describe your volunteer efforts that have impacted education and the communities in which you have lived or served:
* I do hereby apply for review of this application for qualification as a future initiate in the Alpha Epsilon Xi chapter of Kappa Delta Pi, The International Honor Society in Education at Walden University.
* I do understand that a review of my GPA will be conducted by chapter counselors and advisors who are faculty members at Walden University.
*I do also understand that chapter officers who are students and/or volunteers at Walden University will review my application materials to determine if I meet the Honor Society criteria for acceptance to become an initiate of the Alpha Epsilon Xi chapter and then after completing of either the in-person initiation or the online initiation, payment of dues, fulfillment of the GPA requirements, and course credit requirements, then I will be considered qualified for membership in the chapter and in Kappa Delta Pi.
* I give the officers and counselors/advisors of the Alpha Epsilon Xi chapter of Kappa Delta Pi at Walden University Permission to review all materials I have submitted to determine that I meet the requirements for the honor of being selected to be a member in this honor society at Walden University.
If having problems with the form, please upload it here –
Once complete, please email it to firstname.lastname@example.org