LCTA Membership Enrollment Form

COMMUNITY- ADVOCACY- PROFESSIONALISM Trusted and Respected

personal-information-1

First Name *

Middle Name

Last Name *

billing-address

Mailing Country *

Mailing Address *

Mailing City *

Mailing State *

Mailing Zip Code *

personal-information-2

Mobile Phone

Preferred Phones

preferred

Personal E-mail *

custom-field-1

Recruiter's full name (Who asked you to join?) *

payroll-deduction

membership-wrapper

Select your membership category

Dues Amount

$0.00

Total * draft

privacy-policy

custom-legal-wrapper

Authorize 1

LCTA dues include year-round coverage in twelve payments.

Payroll Deduction: I hereby agree to pay and authorize my employer to deduct the dues and assessments described below and as are certified by the Association of the School board for each year thereafter from my salary and direct and authorize my employer to pay such amounts to the Association in accordance with payroll deduction procedures in effect; provided, however. I may cancel my membership and this authorization by providing 30 days of written notice to the School Board and Association notifying them of such revocation as provided by law. Cash Member: I hereby agree to pay to the association the dues and assessments described below and as may be prescribed by the Association and certified to the School Board for each year thereafter.

Print your name

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Math question * 2 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

Leave this field blank

We're sorry but our site requires JavaScript enabled in your browser.

$0.00