LCEA Online Membership Form

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First Name *

Middle Name

Last Name *

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Mailing Country *

Mailing Address *

Mailing City *

Mailing State *

Mailing Zip Code *

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Personal E-mail *

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Home or Mobile Number *

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EIN *

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School Worksite with Position *

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How did you hear about joining LCEA?

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If a colleague referred you to join LCEA, please provide their name here.

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Select your membership category

Dues Amount

$0.00

Total * draft

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Authorize

I agree to be a member of Lake County Education Association, authorize LCEA to represent me to the fullest extent of the law, and accept the terms of the agreement below.

By providing the information on this form, I authorize LCEA 3783 and the American Federation of Teachers (AFT) to deduct dues for membership per the above information and in accordance with the Lake County Education Association - Local 03783 constitution, the state constitution and the AFT constitution. Dues payments are not deductible as charitable contributions for federal income tax purposes, but a portion thereof may be deductible as a miscellaneous itemized deduction. The dues amount may change if authorized according to the requirements of the local, state or national constitutions. If this happens, I authorize my bank or credit card to adjust my payment when notified by LCEA. I agree this authorization remains in effect until terminated in writing by me or until LCEA is given written notification of my separation from my employer and/or the bargaining unit.

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