Join or Renew Online Membership

WSSRA MEMBERSHIP FORM

A auto payment $84.00 will be charged to your Credit/Debit Card annually.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone Number

Cell Phone Number

Personal Email*

Confirmation Emailexample@example.com

SS Number

Please select your Unit.

What Unit do you want to belong to?

Retirement Date

(Month and Year)

Retirement Plans

School District (where last employed)

What School District where you where last employed?

How did you hear about us?

Agent:

Please let us know the Agent or AMBA Representative that assisted you?

Dues:

WSSRA($84.00 for each year)

Membership Dues

Email

Please enter your zip code in the box that says 12345.

Last Name*

Middle Name

First Name*