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.

School Worksite (*Required)

BVSD Employee ID (*Required)

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

Work Email @bvsd.org (*Required)

Full Legal Name (*Required)

Your Birth Month MM (*Required)

Your Birth Day DD (*Required)

Your Birth Year YY (*Required)

Your Ethnicity

Your Gender

Address Line 1 (*Required)

Address Line 2

City (*Required)

St Zip (*Required)

Cell Phone (*Required)

Home 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.

Position: I am a... (*Required)

Grade Level if applicable

Subject Area if applicable

Are you a US Citizen? (*Required)
NoYes

Registered Voter? (*Required)
NoYes

Political Party Affiliation

Please select if you are a full time or part time employee. If this is your first year of teaching anywhere, you are eligible for a discounted rate this year. See Rates below.

Full-time educatorPart-time educatorFull-time first yearPart-time first year

Association Representative

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

Rates for 2022-2023 (August 1 – July 31) (NEA + CEA + BVEA = Total/12 months) = Monthly deduction
Note: Not deductible as a charitable contribution but may be deductible as a miscellaneous itemized deduction.

- Full-time educator ($204 + $442 + $322.38 = $968.38/12) = $80.70/monthly deduction

- Part-time educator, < 0.62 FTE ($113.50 + $221 + $161.19 = $495.69/12) = $41.31/monthly deduction

The definition of a first-year applicant is someone that is teaching for the first time ever.

- Full-time first year ($204 + $250 + $322.28 = $776.38/12) = $64.70/monthly deduction

- Part-time first year, < 0.62 FTE ($113.50 + $125 + $161.19 = $399.69/12) = $33.31/monthly deduction

*Phone number disclaimer: By providing my phone number, I understand that the NEA, the CEA, the local association, NEA Member Benefits, and NEA360, may use automated calling techniques and/or text message me on my cellular phone on a periodic basis. The NEA, CEA, and the local association will never charge for text message alerts. Carrier message and data rates may apply to such alerts.

PLEASE READ THE BELOW LEGAL STATEMENT CAREFULLY:
I hereby request and authorize the Boulder Valley School District to deduct from my earnings and transmit to the Boulder Valley Education Association (BVEA) the amount determined by BVEA (pursuant to Article V of the BVEA By-Laws), CEA, and NEA each year, to be deducted and transmitted in equal monthly installments. This authorization shall continue in full force and effect unless revoked by me in writing and delivered to BVEA between June 1-30 of any calendar year after the date designated below or authorized by a vote from the BVEA Executive Board. The BVEA dues obligation is spread over 12 months to make the monthly deduction more financially friendly to members and to make it possible to plan the annual BVEA budget. I understand that part of my monthly deduction includes a voluntary political contribution to the Every Member Option (EMO) in support of pro-public education legislation and candidates. I may request that those contributions be refunded by BVEA and/or CEA by notifying each organization in writing prior to December 15.

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 Cup.

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.