Wisconsin Association for Health, Physical Education, Recreation, and Dance (WAHPERD)

Online Membership Application Form

Two steps are required to process your online membership application form. The first step is to send us your personal information. The second step is to make your secure online payment.

Step 1: Send us your personal information

I. General Information
From: Month Year To: Month Year
Membership Type (Select One): Current New Renewal of Expired Membership

II. Contact Information
First Name: Last Name:
Street:
County: City: State: Zip:
Home Phone: Work Phone:
E-mail Address:

III. Students Only
School Attending:
Year (Select One): Freshman Sophomore Junior Senior Graduate 

IV. Primary Area of Interest (Select One)
Health - H General - G Physical Education - P Student - S
Sports & Athletics - A Recreation - R  Dance - D  

V. District (Select One)
SE – Southeast District - CESA District 1
SC – South Central District - CESA District 2
SW – Southwest District - CESA Districts 3 & 4
C – Central District - CESA District 5
E – Eastern District - CESA Districts 6 & 7
NE – Northeast District - CESA Districts 8 & 9
NW – Northwest District - CESA Districts 10, 11, & 12