BVESP Membership Enrollment Form & Salary Deduction Authorization

Boulder Valley Paraeducator Association • Boulder Valley Classified Employees 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 BVESP Membership.

School Worksite (*Required)

BVSD Employee ID (*Required)

Work Phone

Work Email @bvsd.org (*Required)

Legal Name (*Required)

Birth Month MM (*Required)

Birth Day DD (*Required)

Birth Year YY (*Required)

Ethnicity (Optional)

Gender (Optional)

Address Line 1 (*Required)

Address Line 2

City (*Required)

State, Zip (*Required)

Cell Phone (*Required)

Home Phone (or SAME as cell)

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.

Are you a US Citizen? (*Required)
NoYes

Registered Voter? (*Required)
NoYes

Political Party Affiliation

Are you a 260 day employee? (*Required)
NoYes

Job category: Please select your job category for BVPA (Paras) or BVCEA (Classified)
Health clinic aideParaeducatorSPEDBus DriverBus AssistantCustodianSecurityGroundsWarehouseVehicle MechanicHVACKitchen LeadProduction CookTradeOther

If you choose Other above please specify:

If you choose Trade above please specify:

Job Title (if applicable):

Grade Level (if applicable):

Member Who Signed Up the New Member

Step 2 - Please read the legal statement and disclaimer, then sign and date your legal document:

Monthly dues will come out of each BVSD Payroll check you receive.

Rates for 2022-2023 (August 1 – July 31) (NEA + CEA + BVEA = Total/12 months) = Monthly deduction

BVCEA (Boulder Valley Classified Employees Association):

- 12-Month (260 days) Employee ($122.50 + $157+ $82.50 = $362/12) = $30.17/monthly deduction

- 10-Month Employee ($73 + $78.50 + $56 = $207.50/10) = $20.75/monthly deduction

BVPA (Boulder Valley Paraeducators Association):

- 10-Month Paraeducator ($73 + $78.50 + $96.50 = $248/10) = $24.80/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.

ACTIVE MEMBERS, PLEASE READ THE BELOW LEGAL STATEMENT CAREFULLY:
I hereby authorize continuing payment or salary deduction of unified dues (national, state, local, UniServ as applicable). Furthermore, I understand that this authorization shall continue in full force and effect unless revoked by me in writing and delivered to BVCEA between August 1-15 of any calendar year after the date designated below or authorized by vote of the BVCEA Executive Board. I hereby authorize my employer to deduct dues from my salary as arranged with my Local Association.

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 Car.

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.