BVEA Membership Enrollment Form & Salary Deduction Authorization

Boulder Valley Education Association • Colorado Education Association • National Education Association

Help save a tree! Complete the form below to join Boulder Valley Education Association (BVEA). Complete this easy 3-step legal membership enrollment form.

Step 1: please complete all of the empty fields below. Step 2: please read this document carefully. Final step 3: sign this form by using your mouse (if you’re using a desktop/laptop computer) or use your finger (if you’re using a mobile/tablet device) and click on the “Submit” button. And, you’re finished.

Congratulations! You will receive a copy of your legal binding document for your records via email after completion.

Step 1 - Fill out the fields below completely and accurately.

This is a legal binding document for registration. Do NOT fill this out unless you want to officially join or renew your BVEA Membership.

MEMBERSHIP COMMITMENT: YES!
I want to join my fellow employees and become a member of the Boulder Valley Education Association (BVEA), the Colorado Education Association (CEA), and the National Education Association (NEA). I hereby request and voluntarily accept membership in these associations and agree to abide by the Constitution and Bylaws of all three associations. (*Required)

Yes, I agree to the membership commitment.

ANNUAL PAYMENT AUTHORIZATION: YES!
I hereby agree to pay the annual (August 1 – July 31) dues established by the three associations in consideration for the services the union provides. I understand that those annual amounts are subject to periodic change by the governing bodies of the associations. I authorize on a continuing basis, and regardless of my membership status, the payment of those annual amounts established by the three associations through payroll deduction unless revoked by me in writing and delivered to BVEA between June 1-30 of any calendar year after the date designated below. I understand that a portion of my dues includes a contribution to Every Member Option (EMO) per the terms set forth below.** (*Required)

Yes, I agree to the annual payment authorization.

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. (*Required)

Today's Date: (*Required)

School Worksite (*Required)

BVSD Employee ID (*Required)

First Name (*Required)

Last Name (*Required)

Date of Birth (*Required)

Personal Email (*Required) Note: this is where you will receive communications from BVEA including this legal document as an attachment. Can NOT be your work email, for legal reasons.

Cell Phone (*Required)

Home Address (*Required)

City (*Required)

St Zip (*Required)

Work Email @bvsd.org (*Required)

Work Phone 720-561-XXXX enter last 4 digits only

Your Ethnicity
Native American/Alaska NativeBlack or African-AmericanLatin/o/a/x, Hispanic, or Chicano/a/xNative Hawaiian/Pacific IslanderAsianWhite (not Hispanic)MultiracialOther

Your Gender
FemaleMaleTransgender FemaleTransgender MaleGender Expansive/Non-Conforming

Are you a US Citizen? (*Required)
YesNo

*Phone number disclaimer: * By providing my cell phone number, I understand that the National Education Association and its affiliates, including the Colorado Education Association (CEA), the Boulder Valley Education Association (BVEA), NEA Member Benefits and NEA360, may use automated calling techniques and/or text message me on a periodic basis. These entities will never charge for text message alerts. Carrier message and data rates may apply to such alerts.

Please select if you are a full time or part time employee. If you are a first-time teacher, kindly choose the "first-year" option to benefit from this year's discounted rate.

Full-timePart-timeFull-time first yearPart-time first year

Position (*Required)

Grade Level if applicable

Subject Area if applicable

Association Representative

Step 2 - Read the legal statement, sign and date your legal document.

Rates for 2023-2024 (August 1 – July 31) (NEA + CEA + BVEA = Total/12 months) = Monthly deduction

Full-time educator = $84.14; Part-time educator, < 0.62 FTE = $43.03; Full-time first year = $67.60; Part-time first year, < 0.62 FTE = $34.76

**The CEA Active full-time membership dues for teachers, building principals, and college faculty includes $43 Every Member Option (EMO) for political activities and $15 Public Relations Assessment for CEA's advertising campaign. The CEA Active full-time membership dues for Education Support Professionals includes $21.50 EMO and $7.50 PR Assessment. EMO and the PR Assessment are pro-rated for part-time members. BVEA membership dues include an $18 voluntary political contribution to Every Member Option (EMO) in support of pro-public education legislation and candidates.

You may request that those contributions be refunded by BVEA and/or CEA by notifying each organization in writing prior to December 15. The CEA will refund the EMO by check if the member notifies CEA in writing by email on the CEA website, coloradoea.org. CEA notifies all Active members who join after November 15 about EMO. There is EMO refund information at coloradoea.org. Providing U.S. Citizen information is voluntary, it is collected in order to refund Every Member Option contributions to non-U.S. citizen members in accordance with Colorado law. Only U.S. citizens may contribute to EMO.

USING YOUR MOUSE (DESKTOP) OR FINGER (MOBILE TOUCHSCREEN DEVICE) PLEASE SIGN IN THE BOX PROVIDED BELOW. BY SIGNING THIS LEGAL DOCUMENT YOU AGREE WITH THE ABOVE STATEMENT AND CONFIRM THAT ALL THE INFORMATION YOU PROVIDED IS TRUE. AGREEMENT, SIGNATURE, AND SIGNATURE DATE IS REQUIRED FOR REGISTRATION. Your Signature confirming agreement: (*Required)

Today's Date: (*Required)

Step 3 - Submit your legal registration document.

Please prove you are human by selecting the tree.

Please don't reload your page or you will lose your data. We appreciate your patience. The submission process takes 20-30 seconds for completion. Upon successful submission, you will receive a confirmation email with your legal document and a summary of your data. If you do not receive the email within 3 minutes check your spam/junk folder.