APPLICATION for CONTINUOUS RETIRED MEMBERSHIP EDUCATION MINNESOTA An affiliate of the American Federation of Teachers, the National Education Association and AFL-CIO. 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Spanish origin) (05)Asian (06)Native Hawaiian/Pacific Islander (07)Multi-ethnic (08)Other (09)Unknown (UK)First year of employment as an educator(Required)Age at retirement(Required)Official retirement date(Required) MM slash DD slash YYYY Name of local retired from(Required)ADA-BORUPADRIANAITKINAITKIN ESPALBANYALBANY ESPALBERT LEAALBERT LEA ESPALDEN-CONGERALEXANDRIAANNANDALEANNANDALE ESP CUSTODIANSANOKA HENNEPINANOKA HENNEPIN ESPANOKA HENNEPIN ESP SCH/KIND READINESSASHBYATWATER-COSMOS-GROVE CITYAUSTINBADGERBAGLEYBARNESVILLEBARNUMBATTLE LAKEBECKERBELGRADE-BROOTEN-ELROSABELLE PLAINEBELLE PLAINE ESPBEMIDJIBEMIDJI REGIONAL INTERDISTRICTBENSONBENTON-STEARNSBERTHA-HEWITTBIG LAKEBLACKDUCKBLOOMING PRAIRIEBLOOMINGTONBLOOMINGTON ESPBLUE EARTH AREABOLDBRAHAMBRAINERDBRAINERD ESP EDUCATIONAL ASSISTANTSBRAINERD ESP FOOD SERVICEBRANDON-EVANSVILLEBRECKBRECKENRIDGEBREWSTER-ROUND LAKEBROOKLYN CENTERBROWERVILLEBROWNS VALLEYBUFFALOBUFFALO ESPBUFFALO LAKE-HECTOR-STEWARTBURNSVILLEBUTTERFIELD-ODINBUTTERFIELD-ODIN ESPBYRONBYRON ESPCALEDONIACALEDONIA ESPCAMBRIDGE-ISANTICAMPBELL-TINTAHCANBYCANNON FALLSCANNON VALLEY COOPCANNON VALLEY COOP ESPCARLTONCASS LAKECEDAR MOUNTAINCENTENNIALCENTRAL TEACHERSCHASKACHATFIELDCHISAGO LAKESCHISHOLMCHOKIO-ALBERTACLEARBROOK-GONVICKCLEVELANDCLIMAXCLINTON-GRACEVILLE-BEARDSLEYCLOQUETCOLUMBIA HEIGHTSCOMFREYCOOK COUNTYCROMWELL-WRIGHTCROOKSTONCROOKSTON ESPCROSBY-IRONTONDAKOTA COUNTY ESPDAKOTA COUNTY UNITED EDUCATORSDASSEL-COKATODAWSON-BOYDDEER RIVERDELANODETROIT LAKESDETROIT LAKES ESPDILWORTH-GLYNDON-FELTONDOVER-EYOTADULUTHDULUTH ESP CLERICALDULUTH ESP-INTEGRATION SPECIALISTSEAST CENTRALEAST GRAND FORKSEAST GRAND FORKS ESPEDEN PRAIRIEEDEN VALLEY-WATKINSEDGERTONEDINAEDINA ESP HEALTH SERVICEELK RIVERELLSWORTHELYEMF-ART AND SCIENCE ACADEMYEMF-CMTY SCHOOL OF EXCELLENCEEMF-TC GERMAN IMMERSIONEMF-TC GERMAN IMMERSION ESPESKOEVELETH-GILBERTFAIRMONTFAIRMONT ESPFAIRMONT ESP PARASFARIBAULTFARMINGTONFARMINGTON ESPFERGUS FALLSFERGUS FALLS ESPFERTILE-BELTRAMIFILLMORE CENTRALFISHERFLOODWOODFOLEYFOLEY ESPFOREST LAKEFOREST LAKE ESPFOSSTONFRAZEEFRESHWATER EDUCATION DISTRICTFRIDLEYFRIDLEY ESP CUSTODIANSFULDAGIBBON-FAIRFAX-WINTHROPGLENCOE-SILVER LAKEGLENVILLE-EMMONSGOODHUEGOODHUE COUNTY ED DIST ESPGOODHUE COUNTY ED DISTRICTGOODRIDGEGRANADA-HUNTLEY-EAST CHAINGRANADA-HUNTLEY-EAST CHAIN ESPGRAND MEADOWGRAND RAPIDSGRAND RAPIDS ESP EDUCATION ASSISTANTSGRAND RAPIDS ESP SECRETARIESGREENBUSH-MIDDLE RIVERGREENWAYGRYGLA-GATZKEHANCOCKHASTINGSHAWLEYHAWLEY ESPHAYFIELDHAYFIELD-BROWNSDALE ESPHENDRICKSHENNINGHERMANHERMANTOWNHERON LAKE-OKABENAHIAWATHA VALLEY ED DISTHIAWATHA VALLEY ED DIST ESPHIBBINGHILL CITYHILL MURRAYHILLS-BEAVER CREEKHINCKLEY-FINLAYSONHOLDINGFORDHOPKINSHOUSTONHOWARD LAKE-WAVERLY-WINSTEDHUTCHINSONHUTCHINSON ESPINTERMEDIATE DISTRICT 287INTERMEDIATE DISTRICT 916INTERMEDIATE DISTRICT 916 ESP PROGRAM ASSISTANTSINTERMEDIATE DISTRICT 917INTERMEDIATE DISTRICT 917 ESP NURSESINTERMEDIATE DISTRICT 917 ESP PROGRAM ASSISTANTSINTERNATIONAL FALLSINTERNATIONAL FALLS ESPINVER GROVE HEIGHTSINVER GROVE HEIGHTS ESPISLEJACKSON COUNTY CENTRALJANESVILLE-WALDORF-PEMBERTONJORDANKASSON-MANTORVILLEKASSON-MANTORVILLE ESPKELLIHERKELLIHER ESPKENYON-WANAMINGOKENYON-WANAMINGO ESPKERKHOVEN-MURDOCK-SUNBURGKIMBALLKIMBALL ESPKINGSLANDKITTSON CENTRALLA CRESCENTLAC QUI PARLELAKE BENTONLAKE CITYLAKE CRYSTAL WELLCOME MEMORIALLAKE OF THE WOODSLAKE PARK-AUDUBONLAKE SUPERIORLAKEVIEWLAKEVILLELAKEVILLE ESPLAKEVILLE ESP KID ZONELANCASTERLANESBOROLAPORTELAPORTE ESPLE SUEUR-HENDERSONLEROY-OSTRANDERLESTER PRAIRIELEWISTON-ALTURALINCOLNLITCHFIELDLITTLE FALLSLITTLEFORK-BIG FALLSLONG PRAIRIE-GREY EAGLELUVERNELYLELYNDMABEL-CANTONMACCRAYMADELIAMAHNOMENMAHTOMEDIMAHTOMEDI ESPMANKATOMAPLE LAKEMAPLE RIVERMARSHALLMARSHALL COUNTY CENTRALMARTIN COUNTY WESTMARTIN COUNTY WEST ESPMAWSECOMCGREGORMEDFORDMELROSEMELROSE ESPMENAHGAMENAHGA ESPMESABI EASTMILACAMILROYMINNEAPOLISMINNEAPOLIS JEWISH DAY SCHOOLMINNEOTAMINNESOTA STATE COLLEGE FACULTYMINNETONKAMINNEWASKAMONTEVIDEOMONTICELLOMOORHEADMOOSE LAKEMORAMORA ESPMORRIS AREAMORRIS AREA ESPMOUNDS VIEWMOUNTAIN IRON-BUHLMOUNTAIN LAKEMURRAY COUNTY CENTRALMURRAY COUNTY CENTRAL ESPNASHWAUK-KEEWATINNETT LAKENEVISNEW LONDON-SPICERNEW LONDON-SPICER ESPNEW PRAGUENEW ULMNEW ULM ESPNEW YORK MILLSNICOLLETNORMAN COUNTY EASTNORMAN COUNTY WESTNORTH BRANCHNORTH BRANCH ESPNORTH ST PAUL-MAPLEWOOD-OAKDALENORTHFIELDNORTHFIELD ESPNORTHLAND LEARNING CENTERNORTHLAND REMERNRHEGNRHEG ESPNW REGIONAL INTERDISTRICT COUNCILOGILVIEOGILVIE ESPONAMIAORONOORTONVILLEOSAKISOSSEOOSSEO ESP ADMINISTRATIVEOSSEO ESP PARAPROFESSIONALSOWATONNAOWATONNA ESPPARK RAPIDSPARKERS PRAIRIEPAYNESVILLE AREAPAYNESVILLE ESPPELICAN RAPIDSPEQUOT LAKESPEQUOT LAKES ESPPERHAMPIERZPIERZ ESPPILLAGERPINE CITYPINE ISLANDPINE RIVER-BACKUSPIPESTONE AREAPIPESTONE AREA ESPPLAINVIEW-ELGIN-MILLVILLEPRINCETONPRINCETON ESP CUSTODIANSPRINCETON ESP PARAPROFESSIONALSPRINCETON ESP SECRETARIESPRIOR LAKE ESP SECRETARIESPRIOR LAKE-SAVAGEPROCTORRANDOLPHRED LAKERED LAKE COUNTY CENTRALRED LAKE FALLSRED ROCK CENTRALRED ROCK CENTRAL ESPRED WINGRED WING ESPREDWOOD FALLSRENVILLE COUNTY WESTRENVILLE COUNTY WEST ESPRICHFIELDRIVER BENDROBBINSDALEROCHESTERROCHESTER ESPROCKFORDROCORIROSEAUROSEVILLEROTHSAYROUND LAKE-BREWSTER ESPROYALTONROYALTON ESPRUM RIVER SPECIAL EDUCATION COOPRUNESTONERUNESTONE AREA EDUCATION DIST ESPRUSH CITYRUSHFORD-PETERSONRUSHFORD-PETERSON ESPRUSSELL-TYLER-RUTHTONSARTELLSAUK CENTRESAUK RAPIDS-RICESEBEKASEBEKA ESPSHAKOPEESIBLEY EASTSLEEPY EYESOUTH KOOCHICHING-RAINY RIVERSOUTH ST PAULSOUTH ST PAUL ESPSOUTH WASHINGTON COUNTYSOUTHERN PLAINS EDUCATION COOPSOUTHERN PLAINS ESPSOUTHLANDSOUTHWEST METROSOUTHWEST/WEST CENTRAL SRVC COOPSOUTHWEST/WEST CENTRAL SRVC COOP ESPSPRING GROVESPRING LAKE PARKSPRINGFIELDST ANTHONY VILLAGEST CHARLESST CLAIRST CLOUDST CROIXST CROIX ESPST CROIX RIVER EDUCATION DISTRICTST FRANCISST JAMESST JAMES ESPST JAMES ESP CUSTODIANSST LOUIS COUNTYST LOUIS PARKST LOUIS PARK ESPST MICHAEL-ALBERTVILLEST PAULST PETERST PETER ESPSTAPLES-MOTLEYSTATE RESIDENTIAL SCHOOLSSTEPHEN-ARGYLESTEWARTVILLESWANVILLETHIEF RIVER FALLSTORAH ACADEMYTRACYTRI COUNTYTRI-CITY UNITEDTRI-CITY UNITED ESPTRITONTRITON ESPTRUMANUEAULEN-HITTERDALUNDERWOODUNITED SOUTH CENTRALUNITED SOUTH CENTRAL ESPUPSALAVERNDALEVIRGINIAWABASHA ESPWABASHA-KELLOGGWABASSOWACONIAWACONIA ESPWADENA-DEER CREEKWADENA-DEER CREEK ESPWALKER-HACKENSACK-AKELEYWARREN-ALVARADO-OSLOWARROADWASECAWATERTOWN-MAYERWATERTOWN-MAYER ESPWATERVILLE-ELYSIAN-MORRISTOWNWATERVILLE-ELYSIAN-MORRISTOWN ESPWAUBUNWAYZATAWEST CENTRAL AREAWEST ST PAULWESTBROOK-WALNUT GROVEWESTONKAWHEATONWHITE BEAR LAKEWILLMARWILLOW RIVERWILLOW RIVER ESPWINDOMWIN-E-MACWIN-E-MAC ESPWINONAWINONA ESPWORTHINGTONWRENSHALLWRIGHT TECH CENTERYELLOW MEDICINE EASTZUMBROTA-MAZEPPAZUMBROTA-MAZEPPA ESPEMF-GREAT RIVER SCHOOL UNIONEMF-HIAWATHA ACADEMIES WORKERS UNION