Alternate membership enrollment - Education Minnesota

Active membership application

"*" indicates required fields

Personal information

Name*

First Middle Last

Prefer to be called

Former last name

The last 4 digits of your Social Security Number*

Date of birth*

Month

Day

Year

Ethnicity

Gender identification

Contact information

Address*

Street Address Address Line 2 City State/Province ZIP / Postal Code Country

Enter at least one email address:
Note: We prefer to use your personal email.

Personal email

Work email

I prefer:

Personal email

Work email

Enter at least one phone number:

Home phone

Mobile phone

Consent to texts

Receive SMS/Text Messages

By selecting Receive Texts, I understand that NEA, its state and local affiliates, NEA Member Benefits and NEA360 may use automated calling techniques and/or text message me on my cellular phone on a periodic basis. These groups will never charge for text message alerts. Text STOP in reply to any text message to stop receiving text from the entity that sent the message. Or reply HELP for more information. Carrier message and data rates may apply.

Workplace information

Employer/district name*

Work location name*

Position type*

Certified Active Professional/Teacher/Faculty

Education Support Professional

Position*

Primary subject

Employment start date in this district*

MM slash DD slash YYYY

Employee #

Experience*

New educator

Worked previously in:

Last district of employment

Membership level

Teacher (percentage of full-time):*

ESP (annual gross):*

National and state dues and assessments

Note: The above amount is only state and national dues. Your local dues (and possibly IO dues) are not included in this amount, but will be deducted at the same time as the state and national.

Local

Membership consent*

Membership consent

Yes, I want to join with my fellow employees and become a member of my local union, Education Minnesota, the National Education Association and American Federation of Teachers. I hereby request and voluntarily accept membership in these associations and agree to abide by the Constitution and Bylaws of all four associations.

Dues amount*

I agree to the above dues and fees amount.

Membership dues, fees and assessments and any voluntary contributions for the school year ending Aug. 31, 2025, and will be deducted from your paychecks throughout the school year.

Payroll deduction*

Payroll deduction authorization

I authorize my employer to deduct and remit to my local from my pay in each pay period a pro-rata portion of the annual dues, fees and assessments required for membership in my local, Education Minnesota, the National Education Association and American Federation of Teachers, the current rates for which are listed on this application. I fully understand that the annual dues required for membership in the four associations are subject to periodic change by the governing bodies of the associations and authorize my local to deduct any modified monthly dues, fees and assessments established by those governing bodies unless my obligation to do so ends under one of the circumstances set forth below. This authorization continues from year-to-year, regardless of my membership in the union, unless: (a) I revoke it by submitting written notice to the local union during the thirty-day period that begins on Sept. 1 and ends on Sept. 30, in which case my revocation will take effect on Oct. 1 in the year in which I submit the notice; or (b) my employment with my current employer ends. If any provision of this agreement is determined to be unlawful or invalid, the remaining provisions will remain in effect.

Contributions disclaimer

Political Action Committee (PAC): Your dues include $25 per year for the Education Minnesota PAC. The PAC uses these contributions to fund political action efforts to strengthen the collective voice of educators in public policy making. A request for a refund of the Education Minnesota Political Action Committee contribution will not affect membership rights or benefits. Only United States citizens should contribute to the Education Minnesota Political Action Committee.

Foundation for Excellence in Teaching & Learning: Your dues include $5 per year toward the Education Minnesota Foundation. The foundation uses these contributions to fund member grants as well as workshops that support and promote access to learning and excellence in teaching.

Members desiring a refund from either the PAC or the foundation must mail, email or hand deliver a signed original refund request form specifying the member’s refund request within 30 days of submitting this membership application form. Refund requests must be resubmitted annually no later than Oct. 31. Members can request the form by calling 800-652-9073.

Tax deduction disclosure

Dues, including contributions to the PAC and Education Minnesota Foundation, are not tax deductible as charitable contributions. The annual dues rate will apply unless you join midyear, in which case your dues will be prorated for that membership year.

Voluntary*

I UNDERSTAND THAT THIS AGREEMENT IS VOLUNTARY AND IS NOT A CONDITION OF EMPLOYMENT AND THAT I HAVE THE LEGAL RIGHT TO REFUSE TO SIGN THIS AGREEMENT WITHOUT SUFFERING ANY REPRISAL.

I UNDERSTAND THAT INITIALING A BOX CONSTITUTES A LEGAL SIGNATURE CONFIRMING MY UNDERSTANDING AND AGREEMENT TO THE ABOVE.

Agreement*

I UNDERSTAND THAT INITIALING A BOX CONSTITUTES A LEGAL SIGNATURE CONFIRMING MY UNDERSTANDING AND AGREEMENT TO THE ABOVE.

Signature*

Date*

MM slash DD slash YYYY

CAPTCHA

Active membership application

"*" indicates required fields

Personal information

Name*

First Middle Last

Prefer to be called

Former last name

The last 4 digits of your Social Security Number*

Date of birth*

Month

Day

Year

Ethnicity

Gender identification

Contact information

Address*

Street Address Address Line 2 City State/Province ZIP / Postal Code Country

Enter at least one email address:
Note: We prefer to use your personal email.

Personal email

Work email

I prefer:

Personal email

Work email

Enter at least one phone number:

Home phone

Mobile phone

Consent to texts

Receive SMS/Text Messages

Workplace information

Employer/district name*

Work location name*

Position type*

Certified Active Professional/Teacher/Faculty

Education Support Professional

Position*

Primary subject

Employment start date in this district*

MM slash DD slash YYYY

Employee #

Experience*

New educator

Worked previously in:

Last district of employment

Membership level

Teacher (percentage of full-time):*

ESP (annual gross):*

National and state dues and assessments

Note: The above amount is only state and national dues. Your local dues (and possibly IO dues) are not included in this amount, but will be deducted at the same time as the state and national.

Local

Membership consent*

Membership consent

Dues amount*

I agree to the above dues and fees amount.

Membership dues, fees and assessments and any voluntary contributions for the school year ending Aug. 31, 2025, and will be deducted from your paychecks throughout the school year.

Payroll deduction*

Payroll deduction authorization

Contributions disclaimer

Tax deduction disclosure

Voluntary*

I UNDERSTAND THAT THIS AGREEMENT IS VOLUNTARY AND IS NOT A CONDITION OF EMPLOYMENT AND THAT I HAVE THE LEGAL RIGHT TO REFUSE TO SIGN THIS AGREEMENT WITHOUT SUFFERING ANY REPRISAL.

I UNDERSTAND THAT INITIALING A BOX CONSTITUTES A LEGAL SIGNATURE CONFIRMING MY UNDERSTANDING AND AGREEMENT TO THE ABOVE.

Agreement*

I UNDERSTAND THAT INITIALING A BOX CONSTITUTES A LEGAL SIGNATURE CONFIRMING MY UNDERSTANDING AND AGREEMENT TO THE ABOVE.

Signature*

Date*

MM slash DD slash YYYY

CAPTCHA

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Active membership application

Personal information

Contact information

Workplace information

Membership level

Contributions disclaimer

Tax deduction disclosure

Active membership application

Personal information

Contact information

Workplace information

Membership level

Contributions disclaimer

Tax deduction disclosure

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