APPLICANT INFORMATION
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Date of Birth
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How did you hear about us?
KELLY KIRBY CERTIFICATION
In order to Join the Network, you must provide a copy of your Kelly Kirby Teacher Certification either bysending it by email, by fax or by mail. You application cannot be processed without attaining this copy first.
To send by email: Please send a scanned copy to info@kelly-kirby.com
To send by fax: Please fax a copy to (604) 241-0400
To send by mail: Please send a copy to 40039 Garry Street, Richmond, B.C. V7E 2T9
Sending via: Email Fax Mail Uploaded 
MEMBERSHIP PACKAGE
Choose a Package Platinum($150/yr) Gold($100/yr) Silver($60/yr) 
TERMS & CONDITIONS
(Please Read Carefully. You must accept the terms below to sign up to Join the Kelly Kirby Teacher's Network)
I understand that in order to Join the Kelly Kirby Teacher Network, I have to be a certified Kelly Kirby teacher and must provide proof of this by sending a copy of my teacher's certificate to Kelly Kirby Publications before my application can be processed. I understand that Kelly Kirby Publications will, in an effort to reduce paper waste, be sending correspondence via email and I know it is my responsibility to check my mail regularly.
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