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Walton County Support Professionals 2021-2022
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Walton County Support Professionals Membership/Payroll Deduction Form - $32.33 per month. I authorize my employer, Walton County School District, to deduct the amount indicated and remit as instructed by the Association. I understand that the deduction amount may change and consent to such change without the necessity of additional authorization. This authorization may be revoked with a thirty (30) day written notice to the WCSP.
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Last 4 Social Security Number
First Name
*
Middle Name
Last Name
*
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Mailing Country
*
United States of America
Mailing Address
*
Mailing Suite
Mailing City
*
Mailing State
*
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Indiana
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Louisiana
Maine
Maryland
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Michigan
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
US Virgin Island
Washington
West Virginia
Wisconsin
Wyoming
Mailing Zip Code
*
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Date of Birth
Date
E.g., 2023-12-06
Home Phone
Mobile Phone
Preferred Phones
preferred
preferred
Personal E-mail
*
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District Employee ID
*
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Worksite
*
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Job Title
*
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Ethnicity
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Sex
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Recruiter and Worksite
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Registered Voter
Registered Voter
Yes
No
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Select your membership category
Select your membership category
ESP Over $10,000
ESP Under $10,000
Dues Amount
$0.00
Total
* draft
privacy-policy
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Authorize
I agree to be a member of Walton County Support Professionals, authorize Walton County Support Professionals to represent me to the fullest extent of the law, and accept the terms of the agreement below.
I authorize my employer, Walton County School Board, to deduct the amount indicated and remit as instructed by the Association. I understand that the deduction amount may change and consent to such change without the necessity of additional authorization. This authorization may be revoked with a thirty (30) day written notice to the WCSP.
Print your name
Date
Date
E.g., 2023-12-06
Signature field is required
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Math question
*
11 + 2 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Leave this field blank
