2017-2018 GAE/NEA Membership Enrollment Form - Test Membership year: September 1, 2017 - August 31, 2018 Use the form below to join GAE or renew your annual membership enrollment. Items marked with a star (*) are required. Membership InformationWhat type of member are you? * RequiredSelect Member typeActive Professional Certified Full-TimeActive Educational Support Full-TimeStudentReferred by or School Not listed in Worksite FieldWORK INFOGAE Student Program Online registration is administered by our national affiliate, the National Education Association. Click on the link below to be directed to their site to complete the online enrollment by credit card. Students Enroll here (nea.org)School District * RequiredSelectAppling CountyAtkinson CountyAtlanta Public SchoolsBacon CountyBaker CountyBaldwin CountyBanks CountyBarrow CountyBartow CountyBen Hill CountyBerrien CountyBibb CountyBleckley CountyBrantley CountyBremen CityBrooks CountyBryan CountyBuford CityBulloch CountyBurke CountyButts CountyCalhoun CityCalhoun CountyCamden CountyCandler CountyCarroll CountyCarrollton CityCartersville CityCatoosa CountyCharlton CountyChatham CountyChattahoochee CountyChattooga CountyCherokee CountyChickamauga CityClarke CountyClay CountyClayton CountyClinch CountyCobb CountyCoffee CountyColquitt CountyColumbia CountyCommerce CityCook CountyCoweta CountyCrawford CountyCrisp CountyDade CountyDalton CityDawson CountyDecatur CityDecatur CountyDeKalb CountyDodge CountyDooly CountyDougherty CountyDouglas CountyDublin CityEarly CountyEchols CountyEffingham CountyElbert CountyEmanuel CountyEvans CountyFannin CountyFayette CountyFloyd CountyForsyth CountyFranklin CountyFulton CountyGainesville CityGeorgia Department of EducationGeorgia Department of Juvenile justiceGeorgia Regional Education Service Agencies (RESA's)Gilmer CountyGlascock CountyGlynn CountyGordon CountyGrady CountyGreene CountyGRIFFIN-SPALDING COUNTYGwinnett CountyHabersham CountyHall CountyHancock CountyHaralson CountyHarris CountyHart CountyHeard CountyHenry CountyHouston CountyIrwin CountyJackson CountyJasper CountyJeff Davis CountyJefferson CityJefferson CountyJenkins CountyJohnson CountyJones CountyLamar CountyLanier CountyLaurens CountyLee CountyLiberty CountyLincoln CountyLong CountyLowndes CountyLumpkin CountyMacon CountyMadison CountyMarietta CityMarion CountyMcDuffie CountyMcIntosh CountyMeriwether CountyMiller CountyMitchell CountyMonroe CountyMontgomery CountyMorgan CountyMurray CountyMuscogee CountyNewton CountyOconee CountyOglethorpe CountyPaulding CountyPeach CountyPelham CityPickens CountyPierce CountyPike CountyPolk CountyPulaski CountyPutnam CountyQuitman CountyRabun CountyRandolph CountyRichmond CountyRockdale CountyRome CitySchley CountyScreven CountySeminole CountySocial Circle CitySpalding CountyState Schools- Atlanta Area School for the DeafState Schools- Georgia Academy for the BlindState Schools- Georgia School for the DeafStephens CountyStewart CountySumter CountyTalbot CountyTaliaferro CountyTattnall CountyTaylor CountyTelfair CountyTerrell CountyThomas CountyThomaston-Upson CountyThomasville CityTift CountyToombs CountyTowns CountyTreutlen CountyTrion CityTroup CountyTurner CountyTwiggs CountyUnion CountyValdosta CityVidalia CityWalker CountyWalton CountyWare CountyWarren CountyWashington CountyWayne CountyWebster CountyWheeler CountyWhite CountyWhitfield CountyWilcox CountyWilkes CountyWilkinson CountyWorth CountyIf you do not see your school district in this list, it is unavailable to participate in the online enrollment process at this time. To join, please contact the GAE membership department at (678) 837-1100.School or WorksiteSelectIf your school is not listed, leave blankYour local association * RequiredSelectSchool Employee ID # * RequiredSchool Employee ID # * RequiredPosition * RequiredSelectAdministratorBldg/Gmd Main/Repair SrvsClassroom TeacherCoachCounselorCurriculum SpecialistFood ServicesHealth & Student ServicesLibrarian/Media SpecialistOtherParaeducatorReading SpecialistSecretary/Clerk/Admin ServicesSecurity ServicesSocial WorkerSpecial/Develop EdSpeech/Hearing TherapistTechnical ServicesTransp/Delivery/Vehicle MechanicsUnknownSubject * RequiredSelectAdult Basic EducationArtBasic Ed CurriculumBasic Skills & Remed EdBusiness educationCoachingCommunicationsComputer & Info ScienceDistributive Ed/Co-OpDriver's EdEarly Child DevelopEnglish as a Second LanguageEnglish/Lang ArtForeign Language/LitGeneral SubjectsHealth & Physical EducationHome EconomicsIndustrial ArtsLaw EnforcementMathematicsMusicNo Subject TaughtOtherReadingReligion/PhilosophyScienceSocial Studies/Social SciencesSpecial Ed/Development EdSpeech & DramaVocational & Tech EdMembership DuesGAE annual membership dues include the following refundable contributions: 1. Georgia Association of Educators Foundation - $2 for Active Certified members and $1 for Active Educational Support members. GAE Foundation contributions fund educational scholarships and grants to members and potential educators and are tax deductible as charitable contributions. 2. Georgia Association of Educators-Fund for Public Education (GAE-FPE) - $6 for Active Certified members and $3 for Active Education Support members. GAE-FPE contributions are used for political purposes and are not tax deductible. The GAE-FPE contributes a portion of the political action contributions collected from its members to those local associations that have an established Political Action Committee. GAE Foundation and GAE-FPE contributions are voluntary and members have the right to a refund of these contributions. Send your request for refund of GAE Foundation and/or GAE-FPE contributions in writing to GAE Membership Processing at the address shown below. NEA, GAE, and local association membership dues are not deductible as charitable contributions. Dues payment (or a portion) may be deductible as a miscellaneous itemized deduction. Six percent (6%) of GAE membership dues is attributable to lobbying expenses and is not tax deductible.NEA Annual Dues Price: $0.00 GAE Annual Dues Price: $0.00 Local Annual Dues Price: $0.00 PAC Fees Price: $0.00 Prorated discount for September Price: $0.00 Your total membership dues were prorated by 1 month. You are being charged for 11 months of membership until our next enrollment period in September 2018.Prorated Dues for September & October Price: $0.00 Your total membership dues were prorated by 2 months. You are being charged for 10 months of membership until our next enrollment period in September 2018.Prorated Dues for September - November Price: $0.00 Your total membership dues were prorated by 3 months. You are being charged for 9 months of membership until our next enrollment period in September 2018.Prorated Dues for September - December Price: $0.00 Your total membership dues were prorated by 4 months. You are being charged for 8 months of membership until our next enrollment period in September 2018.Prorated Dues for September - January Price: $0.00 Your total membership dues were prorated by 5 months. You are being charged for 7 months of membership until our next enrollment period in September 2018.Prorated Dues for September - February Price: $0.00 Your total membership dues were prorated by 6 months. You are being charged for 6 months of membership until our next enrollment period in September 2018.Prorated Dues for September - March Price: $0.00 Your total membership dues were prorated by 7 months. You are being charged for 5 months of membership until our next enrollment period in September 2018.Prorated Dues for September - April Price: $0.00 Your total membership dues were prorated by 8 months. You are being charged for 4 months of membership until our next enrollment period in September 2018.Prorated Dues for September - May Price: $0.00 Your total membership dues were prorated by 9 months. You are being charged for 3 months of membership until our next enrollment period in September 2018.Prorated Dues for September - June Price: $0.00 Your total membership dues were prorated by 10 months. You are being charged for 2 months of membership until our next enrollment period in September 2018.Prorated Dues for September - July Price: $0.00 Your total membership dues were prorated by 11 months. You are being charged for 1 month of membership until our next enrollment period in September 2018.Your Total Membership Dues $0.00 Personal InfoSalutation * RequiredMrs.Ms.MissMr.Dr.First Name * RequiredMiddle NameLast Name * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Social Security Number Last Four Digits Only * RequiredDate of Birth - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Date of birth and ethnicity are optional and not a requirement of membershipEthnicitySelectAmerican Indian/Alaska NativeAsianBlackHispanicCaucasian (not of Hispanic origin)Nativ Hawaiian/Pacific IslanderMulti EthnicOtherUnknownDate of birth and ethnicity are optional and not a requirement of membershipMobile Phone * RequiredHome PhonePersonal Email * Required Enter Email Confirm Email Work Email Enter Email Confirm Email Payment OptionsPayment Method * RequiredPayroll DeductionEasy Pay / Electronic Bank DraftDebit / Credit CardPayment MethodEasy Pay / Electronic Bank DraftDebit / Credit CardCredit Card DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name Bank NameBank Routing #Also called Bank Transit NumberBank Account #Checking or Savings Account NumberPay periods per yearSelectPayment per pay periodAmount deducted each pay periodVoided CheckAccepted file types: jpg, jpeg, gif, png, pdf, bmp, tiff.To expedite the enrollment process please upload a photo of voided personal check (if possible)Terms of ServiceTerms of Service * RequiredI hereby apply for continuous membership in GAE/NEA and the local association (if available). I understand that I have signed a binding contract to pay the total annual dues for the current membership year and each year thereafter. I may revoke this authorization only by written notification to GAE, my local association and employer (if applicable) between September 1 and September 30 of each year. I agree to the Terms of Service Last 4 of SSN * RequiredYour IP AddressToday's Date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Electronic Signature * Required
