Membership Checkout – MEA Family RSA

Membership Level change

You have selected the Annual Membership membership level.

One year of RSA membership, with membership continuing through annual payment of dues. If you chose someone at the time you retired to continue receiving your pension after your passing, they will be eligible to continue as an RSA member by paying annual dues.

The price for membership is $52.00

Membership expires after 1 Year.

Account Information Already have an account? Log in here

Username

Password

Confirm Password

First Name

Last Name

Email Address

Confirm Email Address

Full Name LEAVE THIS BLANK

About You

Enter your basic contact information in the fields below.

Preferred Name

What do you prefer to be called? (e.g. "Bill" instead of "William")

Birth Date

Addresses

Enter your primary, and (if applicable) secondary addresses in the fields below.

Primary Address

City

State

ZIP

Do you have another address at which you can be reached?

Yes

Alternate Address

City

State

ZIP

Dates at Primary Address

Dates at Alternate Address

Phone Numbers

Enter your phone number(s) below.

Phone (Home)

Phone (Cell)

Preferred Contact Number

Home

Cell

Retirement Information

Please enter details about your retirement from an MEA Family company in the fields below.

Are you receiving benefits as a beneficiary of an MEA Famly retiree?

Yes

Retiree's Name (if you are a Beneficiary)

If you are not a beneficiary, you do not need to fill out this field.

When did you/the retiree retire from employment?

Enter the date, year, or "Not Sure"

From which MEA Family company did you/the retiree retire?

From which position did you/the retiree retire?

Which benefits do you receive from the MEA Family company?

Please select all that apply. To select multiple items, hold down the Control/Command key.

Beneficiary Information

If you selected a retirement option (at the time of your retirement) that allows a beneficiary to continue to receive your pension and/or health benefits after your death, please enter their information below. Beneficiaries who continue to receive benefits from an MEA Family company after your death are eligible to become RSA members.

Do you have a qualified/eligible beneficiary as defined above?

Yes

Name of Beneficiary

Address

City

State

ZIP

Phone (Home)

Phone (Cell)

Relationship to you?

Emergency Contact

If you would like to designate an emergency contact, please enter their information below. We will only reach out to your emergency contact if we are unable to reach you directly.

Name

Address

City

State

ZIP

Phone (Home)

Phone (Cell)

Relationship to you?

Would you like to set up automatic renewals?

Yes, renew at $52.00 per Year

Choose Your Payment Method

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