New Member Application

Follow these steps to apply for KREIA membership.  Read carefully before starting. Your application is not complete until payment arrangements have been made and payment received.  There is a one-time fee of $30.00 for processing the application & annual dues are $180.00.   In the unlikely event that your membership is not approved, your dues payment of $180.00 will be refunded.  The $30.00 processing fee will not be refunded.

If you have questions about KREIA Membership, please contact the KREIA Membership Committee Chairman, Mike Paris, at 270-485-2662 or email at proviewpro@gmail.com.

  1. Fill out the Membership Application Form below. Indicate whether you want to take advantage of the KREIA Annual Education Pass (gives you access to both the Fall and Spring Conference)
    (Available for new members year round.  Available for existing members only at membership renewal in August – September of each year.)
  2. Click on the “Submit” button at the bottom of the form.  If the form comes back, you missed a *required field.  Check it carefully and resubmit it.
  3. On the next page that appears. select your payment method.

Thank you for applying for membership in KREIA.  Your application will be reviewed by the Membership Committee, one of whom will be contacting you.

New Member Application

  • Fields marked with an asterisk (*) are required.
    If you click the submit button and it brings you back to the top of the form, you missed a required field. Please complete all required fields and then click the submit button again.

  • If you don't know your license number you can find it on the KBHI License Verification website at:

    KBHI License Verification Website Link (Link opens in new window. Switch back to this window to continue)

  • For $200.00, the KREIA Annual Education Pass gives you access to all KREIA Education events, usually two conferences per membership year (September 1st - August 31), in the fall and spring, with a minimum of 14 hours of continuing education at each conference.ce.
  • (PLEASE: Only click the SUBMIT button once. IF the form is still showing on this page after you click the SUBMIT button, you missed a required field. Complete that and then SUBMIT again.)
  • This field is for validation purposes and should be left unchanged.