Other OEA FCPE

Name*

First NameLast Name
Local Association:*
Last 4 digits of SSN*
Note: State law prohibits the Fund from accepting contributions from non-OEA members.
- $ Annual OEA FCPE Amount:
- $ Annual NEA FCPE Amount:
- Deduction contributions shall be deducted in equal installments based on your Local Association schedule.
- Deduction contributions shall be deducted in equal installments based on your Local Association schedule.
- $ OEA FCPE Amount:
- $ NEA FCPE Amount:
- *This is a 1(one) time payment and will be applied to the membership year it is received.
  Please mail check along with a copy of this form to:
  Oklahoma Education Association
  PO Box 18485
  Oklahoma City, OK 73154
- Should be Empty: