CSDREA Membership Application

Membership Application

Please fill out your details to apply for membership.
Agency Retired From*
Retirement Date*

MonthDayYear
Date
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
SSN*
Gender
Marital Status
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you willing to volunteer?*
Which payment option would you prefer to pay your membership dues?*
Pension Deductions

* SDCERS requires you to complete a Pension Deduction Authorization form (PDA). After submitting this form you will be redirected to the PDA to complete this membership application process.
Annual Invoice

* Invoices for memberships begining mid-year will be pro-rated.

* Annual invoices will be issued during the month of December for the following calendar year membership.
By signing this form below, I am confirming that I wish to become a member of the City of San Diego Retired Employees Association. I acknowledge that I am required to pay member dues monthly through pension deductions or annually by invoice. I understand that the dues paid to REA are not tax deductible as a charitable contribution. I also authorize REA and it's affiliate, SDPEBA, to send electronic communications to the email address provided.
Signature*

Clear
Date

MonthDayYear
Date
Should be Empty: