ACH - West Virginia School Service Personnel Association

Name *

First

Last

Email *

County of Employment *

Job Classification *

Work Location

Address *

City *

State *

Zip *

Home Phone

Cell Phone

Work Phone

Classification Category *

Membership Type *

Regular member
Substitute member
State employee member
Retiree member

Dues Amount *

Click here to find dues amount (monthly or yearly) and input above

Payment Frequency *

Monthly
Yearly

Account Type *

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Routing Number: *

Account Number: *

Bank Name *

I authorize WVSSPA (West Virginia School Service Personnel Association) to charge my account for my dues deduction. *

I agree

I understand this is a recurring deduction. Monthly deductions will occur on the 25th or next business day. Yearly deductions will occur on the 25th or next business day the month you authorized deductions. *

I agree

I understand that WVSSPA will not issue refunds because of user error. *

I agree

I agree to notify WVSSPA in writing of any changes in my account information or termination of this authorization 15 days prior to the next due date of the charges. *

I agree