Online Membership Application

Online Membership Application
Do You Have Any Questions?

Read, The Benefits of VSEA Membership: Difference Between A VSEA Member And A Non-Member.

Or, Feel Free To Read The VSEA FAQ!

You can also give us a call at 802-223-5247 or email vsea@vsea.org

Current VSEA Dues Rate: 0.9% of an employee’s hourly pay rate, multiplied by their standard hours per pay period, with a maximum of $32.

An example would be $32.80/hour X 80 hours X 0.009 = a biweekly dues rate of $23.62.
Sign Up Below to Become a VSEA Member:

* indicates required.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Phone Type*

HomeMobile
By sharing your mobile phone number you are automatically opted in to receive text messages from VSEA.
Work Phone
Primary Email (Best email to contact you with)*
example@example.com
Subscribe Primary Email Address To VSEA's Weekly Newsletter
Home Email
example@example.com
Subscribe Home Email Address To VSEA's Weekly Newsletter
Work Email
example@example.com
Subscribe Work Email Address To VSEA's Weekly Newsletter
Job Title
Dept./Agency
Work Station (city/town):
Building Address
Employee #*
Date of Birth

MonthDayYear
Gender Identity (select all that apply)

MaleFemaleNon-binaryGenderqueerGender non-conformingTransgenderAgenderGenderfluidPrefer not to respondOther
Pronouns (select all that apply)

He, Him, HisShe, Her, HersThey, Them, TheirsPrefer not to respondOther
Recruited by
How Did You Hear About Joining VSEA?*

VSEA EmailVSEA WebsiteSocial MediaText MessageVSEA Mailing CardVSEA Meeting or EventNew Employee OrientationVSEA Advantage Discount ProgramOther
Email Type:

VSEA Meeting Announcement EmailVSEA's Weekly Newsletter, Week In ActionVSEA Action AlertVSEA Supplemental Insurance EmailsCorrespondence with VSEA StaffOther
I hereby apply for membership in the VSEA and authorize VSEA to represent me as the exclusive bargaining agent. I authorize payroll to deduct VSEA dues from my salary in the amount certified by VSEA in this and succeeding years of my employment and membership. I understand dues can be changed by the members of VSEA at their annual meeting. I understand this authorization may be revoked at any time with written notice to VSEA and Payroll Officer.*

Yes, I agree and authorize payroll to deduct VSEA dues.
Initial Here*
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