Please Complete This Form to Enroll by Payroll Deduction

If your district is not listed, then we do not currently extend membership benefits to your area.
This is to help us identify you to your district's payroll department.
This is to help us identify you to your district's payroll department.
UEA will submit your notification of drop to the appropriate association for processing. Other associations will generally accept our notices, but are not required to by law. It is good practice to monitor your paycheck to ensure their deductions do not continue. If they do, contact your payroll department.

Payroll Deduction Agreement

I authorize my school district to deduct on a monthly basis the annual dues indicated below. This authorization will remain in effect, including any future increases, until I give written notice of revocation to UEA or the District.   I further authorize any unpaid annual balance to be deducted from my final paycheck.
Clear Signature
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