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

Format: (000) 000-0000.

Cell Phone Number

Format: (000) 000-0000.

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?

WSSRA($84.00 for each year)

Membership Dues

Email

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

Employment Status

Last Name

Middle Name

First Name