Arizona Education Association

Fall 2016

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38 ADVOCATE | FALL 2016 AEA Statement of Ownership Every Member Option On April 24, 2009, over 700 members at the AEA Delegate Assembly voted to establish an annual dues assessment, called the Every Member Option, in the amount of $12. This assessment impacts all active-certified and active-classified working half-time or more. AEA-Retired and active members working less than half-time are assessed $6. Members have the option of receiving a refund for this assessment at the beginning of each membership year. EVERY MEMBER OPTION REFUND REQUEST FORM In accordance with Arizona Education Association (AEA) Bylaw Article I, Section 6, Subd. K-L, I hereby request a refund of the Every Member Option (EMO) annual dues assessment to my AEA dues. All of the following elds are required. Please print legibly. Name _______________________________________ Last 4 digits of SSN _________ Address _______________________________________________________________ City, State, Zip ___________________________________________________________ School District ___________________________________________________________ Phone Number __________________________________________________________ Signature _________________________________________ Date _________________ A request for refund of EMO will not affect membership rights or bene ts. DEADLINE TO REQUEST A REFUND OF EMO BY AEA 1) by October 31 for continuing members; or 2) within 30 days of signing a membership form for new members. Please mail or fax this form to: Arizona Education Association Membership Department Attn: EMO Refund Request 345 E. Palm Lane Phoenix, AZ 85004 Ph: 602-264-1774 x126 Fax: 602-407-2385 FORM 029 05/10 EVERY MEMBER OPTION REFUND REQUEST FORM In accordance with Arizona Education Association (AEA) Bylaw Article I, Section 6, Subd. K-L, I hereby request a refund of the Every Member Option (EMO) annual dues assessment to my AEA dues. All of the following elds are required. Please print legibly. Name _______________________________________ Last 4 digits of SSN _________ Address _______________________________________________________________ City, State, Zip ___________________________________________________________ School District ___________________________________________________________ Phone Number __________________________________________________________ Signature _________________________________________ Date _________________ A request for refund of EMO will not affect membership rights or bene ts. DEADLINE TO REQUEST A REFUND OF EMO BY AEA 1) by October 31 for continuing members; or 2) within 30 days of signing a membership form for new members. Please mail or fax this form to: Arizona Education Association Membership Department Attn: EMO Refund Request 345 E. Palm Lane Phoenix, AZ 85004 Ph: 602-264-1774 x126 Fax: 602-407-2385 FORM 029 05/10 EVERY MEMBER OPTION REFUND REQUEST FORM In accordance with Arizona Education Association (AEA) Bylaw Article I, Section 6, Subd. K-L, I hereby request a refund of the Every Member Option (EMO) annual dues assessment to my AEA dues. All of the following elds are required. Please print legibly. Name _______________________________________ Last 4 digits of SSN _________ Address _______________________________________________________________ City, State, Zip ___________________________________________________________ School District ___________________________________________________________ Phone Number __________________________________________________________ Signature _________________________________________ Date _________________ Please mail or fax this form to: Arizona Education Association Membership Department Attn: EMO Refund Request 345 E. Palm Lane

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