CEA/NEA Membership

JOIN TODAY TO HAVE A COLLECTIVE VOICE FOR QUALITY PUBLIC EDUCATION

To become a member please fill out the form below and we will contact you once we receive your submission.

Last 4 of Social Security#*
Local Association*
School/Worksite*
Name*
First MI Last
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Home Phone
Personal Email*
Date of Birth*
Month
Day
Year
Ethnicity*
Gender*
US Citizen*
- Yes
- No
Registered Voter*
- Yes
- No
Political Affiliation*
- Republican
- Democrat
- Independent
- Other
Political Affiliation Other
Membership Type*
- Full-time
- Part-time or less
- Active K-12 Teacher or College Faculty and Transitional Retiree
- Active Education Support Professional (ESP)
- Substitute
- Other
Membership Type Other: Position
Membership Type Other: Subject
CEA First-Year Dues
- Check here for CEA First-Year Reduced Dues
This is the first year you have ever been employed by any public school district in the US.
Payment*
- Payroll Deduction
- Check/Credit Card
- Electronic Funds Transfer (EFT)
Consent
I have reviewed this form in its entirety and hereby authorize the continuing payment or dues deduction of unified dues (local affiliate, CEA, NEA as applicable) unless I revoke this authorization in writing to my local association or state in accordance with my local association's or state's governing documents. I also authorize modifications of the associations' dues.
Member Signature*
Date*
MM slash DD slash YYYY
Association Rep Name
Work Site
Prove you are human. What letter is missing? A,B,_,D,E*
Name
This field is for validation purposes and should be left unchanged.

The Colorado Education Association works collectively to provide the best public education for every student.

1500 Grant St. Denver, CO 80203 | 303-837-1500 | 800-332-5939 | coloradoea.org | nea.org

2472 Patterson Rd. #13, Grand Junction, CO 81505