WVSSPA Regular Employee membership monthly

Name *

First

Last

Email *

Phone *

County of Employment *BarbourBerkeleyBooneBraxtonBrookeCabellCalhounClayDoddridgeFayetteGilmerGrantGreenbrierHampshireHancockHardyHarrisonJacksonJeffersonKanawhaLewisLincolnLoganMarionMarshallMasonMcDowellMercerMineralMingoMonongaliaMonroeMorganNicholasOhioPendletonPleasantsPocahontasPrestonPutnamRaleighRandolphRitchieRoaneSummersTaylorTuckerTylerUpshurWayneWebsterWetzelWirtWoodWyomingWVSD&BState Employees

Job Classification *CustodianMaintenanceOfficeSchool LunchTeacher AideTransportationRCSDHHRDMVRehab ServicesConcord UniversityDept of AdministrationWV Public Defender ServicesShepherd UniversityOther

Employee ID (optional)

Work location (optional)

Mailing Address *

Address Line 1

Address Line 2

City

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Zip Code

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

• I understand this is a recurring deduction. Monthly deductions will occur on the day you signed up for membership each month. Yearly deductions will occur on the day you signed up for membership each year.

• I understand I will receive email alerts from stripe notifying me of changes, issues and charges to my account.

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

• 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.

Select location for monthly payment *Barbour – $23.83Berkeley – $23.75Boone – $23.75Braxton – $23.25Brooke – $23.75Cabell – $23.33Calhoun – $23.75Clay – $23.33Doddridge – $23.33Fayette – $23.33Gilmer – $23.33Grant – $23.25Greenbrier – $23.33Hampshire – $23.33Hancock – $23.75Hardy – $23.33Harrison – $23.75Jackson – $23.33Jefferson – $24.17Kanawha – $23.67Lewis – $23.25Lincoln – $23.33Logan – $23.33Marion – $24.50Marshall – $23.33Mason – $23.25McDowell – $22.92Mercer – $23.75Mineral – $23.33Mingo – $23.33Monongalia – $23.33Monroe – $23.33Morgan – $23.33Nicholas – $23.33Ohio – $23.75Pendleton – $24.17Pleasants – $23.75Pocahontas – $23.33Preston – $23.42Putnam – $23.75Raleigh – $24.58Randolph – $23.75Ritchie – $23.75Roane – $23.33Summers – $23.33Taylor – $23.33Tucker – $22.92Tyler – $23.33Upshur – $23.08Wayne – $23.75Webster – $23.17Wetzel – $23.33Wirt – $23.33Wood – $24.17Wyoming – $23.33WVSD&B – $23.33State Employees – $23.67

Total per month

$0.00

Stripe Credit Card *

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