UEA Membership Enrollment Form

Submit the completed UEA Membership Enrollment Form via mail to 4900 SE Loop 820, Ste. 200 Fort Worth, TX 76140. You can also email it to join@ueatexas.com or fax it to (817) 572-7736. If paying by check, submission via fax or email is not allowed. It is advisable to send it via mail to ensure it reaches the appropriate destination.

Important dates for this form include the start of the school year and before the district's payroll deduction deadlines. Ensure to submit the form in a timely manner to avoid any delays in membership activation.

The purpose of this form is to allow new and returning members of the United Educators Association to enroll or renew their membership. It is essential for providing necessary information such as personal details, contact information, and payment authorization. By completing and submitting this form, members can ensure their participation in the association and access to its benefits. Additionally, this form allows for the authorization of payroll deductions for membership fees. School district employees can use this form to ensure that their membership fees are automatically deducted from their payroll. Overall, this form is a crucial step in becoming a member or maintaining membership in the United Educators Association.

• 1. School District: The name of the school district where the member is employed.
• 2. Name: The member's full name.
• 3. Social Security Number: The member's social security number for identification purposes.
• 4. Best Contact Phone Number: The member's primary contact phone number.
• 5. District Email Address: The member's email address provided by the school district.
• 6. Employee ID Number: The member's identification number assigned by the school district.
• 7. Home Address: The member's residential address.
• 8. City: The city where the member resides.
• 9. Secondary Email Address: An additional email address for contacting the member.
• 10. Campus / Department: The specific campus or department where the member works.
• 11. ZIP Code: The postal code for the member's home address.
• 12. Position: The job title or position held by the member within the school district.
• 13. Membership Type: The type of membership selected, such as Full Time Professionals, Auxiliary Personnel, etc.
• 14. Payment Authorization: Authorization for payroll deduction or other payment methods for membership fees.
• 15. Signature: The member's signature to authorize payment and confirm the information provided.
• 16. Date: The date when the form is completed and signed.

If you fail to submit this form, you risk not being able to join the United Educators Association or renew your membership. Additionally, you may lose the benefits associated with membership, including payroll deduction for membership fees.

• Membership Ineligibility: Without submission, you cannot become a member or renew your membership in UEA.
• Loss of Benefits: Failure to submit means losing access to UEA membership benefits.
• Payroll Deduction Issues: You will not be able to authorize payroll deductions for membership fees without submitting the form.

• 1. New Membership: Use this form if you are joining UEA for the first time.
• 2. Membership Renewal: Use this form to renew your existing UEA membership.
• 3. Payroll Deduction Authorization: Use this form to authorize payroll deductions for your membership fees.
• 4. District Change: Submit this form if you are changing your associated district.
• 5. Update Information: Use this form to update your personal, contact, or payment information.