Retired Membership

NEA-New Mexico Retired Membership Application Form
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile/Home Phone*
Format: (000) 000-0000.
Personal E-mail
example@example.com
Date of Birth*

MonthDayYear
Date
American Indian/Alaska NativeNative Hawaiian/Pacific IslanderHispanicAsainBlackWhiteMultiple RacesOther
FemaleMaleTransgender FemaleTransgender MaleGender Expansive/Non-ConformingOther
Total Dues. If you are interested in a monthly payment— please call us.*
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Former Certified Retired Annual
NEA Dues- $35 NEA-NM Dues- $25

$60.00



Former Certified Retired Life
NEA Dues- $300 NEA-NM Dues- $200

$500.00



Certified Pre-Retired Life
NEA Dues- $300 NEA-NM Dues- $200

$500.00



Former ESP/Classified Retired Annual
NEA Dues- $21 NEA-NM Dues- $15

$36.00



Former ESP/Classified Retired Life
NEA Dues- $180 NEA-NM Dues- $120

$300.00



ESP/Classified Pre-Retired Life
NEA Dues- $180 NEA-NM Dues- $120

$300.00



Foundation for the Improvement of Education
Optional Contribution

$10.00 Quantity



EdPAC
Optional Contributions

$10.00 Quantity



Total

$0.00
Signature*

Clear
Your e-signature is a verification that you have read and agreed to NEA-NM terms mentioned above.
Today's Date

MonthDayYear
Date
I hereby agree to pay cash (membership does not become effective until payment is recieved), by credit card, or authorize the Educational Retirement Board to deduct dues from my monthly retirement payment.

If you are paying by cash or monthly deductions, please print form once signed and mail to:

NEA-NM Membership Processing

2007 Botulph Road

Santa Fe, NM 87505

I UNDERSTAND THAT THIS AGREEMENT IS VOLUNTARY AND IS NOT A CONDITION OF EMPLOYMENT AND THAT I HAVE THE LEGAL RIGHT TO REFUSE TO SIGN THIS AGREEMENT WITHOUT SUFFERING ANY REPRISAL.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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NEA-New Mexico Retired Membership Application Form