Association Membership Form
Home E-mail Address
Home Phone
School/Work E-mail Address
School/Work Phone
Middle
School/Work Location
ASSN
Social Security Number
Yes
Have you ever been a member before?
First
Local Association Name
(see reference for Local name)
No
Membership
Type
Annual
Amount
NEA
MEA
LOCAL
MEA-FISOPE
Total
Last
NAME
ADDRESS
Please see the reference on page 2 to
determine your membership type.
CITY
STATE
CTRY
ZIP
ETHNICITY
PAY METHOD
SEE CODES ON NEXT PAGE
DATE OF BIRTH
(MM/DD/YYYY)
SUBJECT
POSITION
GENDER
POLITICAL PARTY
In the event that my membership is terminated
before the end of the membership year, my
signature below authorizes that any amount still
owed from this obligation shall be deducted from
the final pay I receive as a member.
REGISTERED VOTER
HIRE DATE
(mm/dd/yyyy)
OCCUPATION (if position not on form)
With full knowledge of the above, I authorize my employer to deduct from my salary and pay to the Local Association, in
accordance with the agreed upon payroll deduction procedure, professional dues as may be determined from time to time and
political action contribution in the amount indicated above for this membership year and each membership year thereafter,
provided that I may revoke this authorization BEFORE SEPTEMBER 15 of any membership year by giving written notice to that
effect to my employer and the Local Association on or before that date.
The MEA Fund in Support of Public Education collects voluntary contributions from Association members and uses these
contributions for political purposes, including, but not limited to, making contributions and expenditures on behalf of friends
of public education who are candidates for state and local office. Contributions to MEA-FISOPE are voluntary; making a
contribution is neither a condition of employment nor membership in the Association, and members have the right to refuse
to contribute without suffering any reprisal. Contributions may only be made by U.S. Citizens or lawful permanent residents.
Dues payments are no deductible as charitable contributions for federal income tax purposes. Dues payments (or a portion) may
be deductible as a miscellaneous itemized deduction. Contributions to MEA-FISOPE are not deductible for income tax purposes.
MEMBER SIGNATURE
(Required for Membership)
DATE
(Required for Membership)
LOCAL ASSOCIATION
REPRESENTATIVE
Please send the signed form to Paul Hambleton via
e-mail [email protected] or mail 35 Community Drive, Augusta, ME 04330
SUBJECT CODES
Adult Education
Agric & Natrl Resources
Art
Basic Ed Curriculum
Basic Skills & Remed Ed
Bilingual Ed
Business Ed
Accounting
Business Ed
Business Math
Data Processing
Coaching
Communications
Computer & Info Science
Distributive Ed/Co-op
Driver’s Ed
Early Child Ed
English/Language Arts
English/Language Arts
Journalism
English as a Second Lang
Foreign Language & Lit
Health & Physical Ed
Home Economics
Industrial Arts
Industrial Arts
Trade & Industrial Ed
Law Enforcement
Marketing
Mathematics
Mathematics
Algebra
Calculus
Functions
Geometry
Trigonometry
Music
Band/Orchestra
Physical Sciences
Physical Sciences
Biology
Chemistry
Earth Science/Geology
Life Sciences
Physics
Reading
Religion/Philosophy
ROTC
ADED
AGNR
ARTS
BEDC
BSRE
BIED
ACCT
BSED
BSMA
DAPR
COCH
COMM
CICS
DECP
DRED
ECDE
ELAR
JOUR
ENSL
FLLI
HEPE
HOME
INAR
TIED
LAEN
MARK
MATH
ALGE
CALC
FUNC
GEOM
TRIG
MUSI
BDOR
PHSC
BIOL
CHEM
ESCG
LISC
PHYS
READ
REPH
ROTC
POSITION CODES
Administrator*
Administrator
Athletic Director
Principal/Assistant Principal
Supervisor/Director
Adult Educator
Bldgs/Grnd Main/Repair Services
Custodian
Electrician
Groundskeeper
Laborer/Helper/Warehouser
Mechanic/Repairer
Building/Grounds-Other
Coach
Counselor
Curriculum Specialist
Food Services
Cook/Food Preparatin Worker
Dietician/Diet Technician
Food Svcs Super/Asst Super
Food Service-Other
Social Studies/Social Sciences
Social Studies/Social Sciences
Civics/Govn/Pol Science
Economics
Geography
History
Psychology
Public Affairs
Sociology
Special Ed/Development Ed
Special Ed/Development Ed
Special/Dev Ed Early Childhd
Cognitive Disabilities
Emotionally Disturbed
Gifted & Talented
Learning Disabled
Multi-Categorical Disabilities
Speech & Hearing Impaired
Visually Impaired
Speech & Drama
Vocational & Tech Ed
No Subject Taught
General Subjects
Other
SSSS
CGPS
ECON
GEOG
HIST
PSYC
PUAF
SOCI
SDED
SDEC
COGN
EMDI
GTAL
LDIS
MCDA
SHIM
VIIM
SPDR
VTED
NONE
GSUB
OTHR
Health & Student Services
Hlth/Ther Asst/Technician
HTAT
Physical Therapist
PHTH
Occupational Therapist
OCCT
Licensed Practical Nurse
LPNU
Registered Nurse
RGNU
Nurse’s Assistant
NUAS
CUST
Medical Technician
MDTC
ELEC
Speech/Hearing Therapist
SHTH
GRND
Social Worker
SCWK
LABR
Psychologist
PSYC
MECH
Health Care/Welfare-Other
HCOT
BGOT
Librarian
LIBR
COCH
Literacy Coach
LITC
CNSL
Paraeducator (Instruct/NonInstructional)
CRSP
ED TECH I
ET01
ED TECH II
ET02
COOK
ED TECH III
ET03
DIET
Monitor/Dorm Attendant
MONI
FSSU
Special Ed Assistant
SEDA
FSOT
Paraeducator-Other
PPOT
ROTC Instructor
ROTC
*Directly hires, evaluates, transfers, disciplines, or dimisses
Secretary/Clerk/Admin Services
Bookkeeper
Clerk/Admin/Office Asst
Secretary/Stenographer
Admin Srvcs Other
Security Services
Guard/Police/Security Worker
Special/Develop Ed
Teacher
Classroom Teacher
Instructional Specialist
Reading Specialist
Web-Based Teacher
Technical Services
Audiovisual/Lang Tech
Comp Prgmr/Sys Anal/DP Spcist
Technical Services-Other
Transp/Delivery/Vehicle Mechanics
Bus/Truck/Van Driver
Vehicle Mechanic
Transportation-Other
No Position Held
Other
ETHNIC CODES*
American Indian/Alaska Native
Black
Hispanic
Caucasian (not of Spanish origin)
Asian
Native Hawaiian/Pacific Islander
Multi-Ethnic
Other
Unknown
METHOD OF PAYMENT
Cash/Check
Payroll
CK
PR
GENDER
Male
Female
M
F
ADMN
ATHL
PRIN
SPRV
ADED
01
03
04
05
06
07
08
09
UK
POLITICAL PARTY
Democrat
Republican
Independent
No Party
Other
REGISTERED VOTER
Yes
No
D
R
I
N
O
Y
N
BKPR
CAOA
SEST
SCOT
GPSW
SDSP
CLTR
INSP
READ
WEBT
SLTC
CPSA
TSOT
BTVD
VEME
TDOT
NONE
OTHR
*Ethnic Minority information is optional and failure to provide it will in no way affect your membership status, rights or benefits in NEA,
MEA, or any of their affiliates. This information will be kept confidential.
**Voluntary information for Affirmative Action is not required as a condition of Membership.
NEA/MEA/LEA membership is open only to those who agree to subscribe to the goals and objectives of the Association and to abide by its
Constitution and Bylaws.
ACSUM (COLT)
ACTON
ACTON SUPPORT STAFF ASSN
AFUM
ALEXANDER
APPLETON TA
ASHLAND AREA TA
ATHENS EA
AUBURN EA
AUGUSTA EA
BANGOR EA
BAR HARBOR TA
BAR HARBOR SUPPORT EA
BASE
BIDDEFORD TA
BIDDEFORD ADMINISTRATIVE
ASSISTANTS ASSN
BIDDEFORD ADMIN
BIDDEFORD ED TECH III
BIDDEFORD SUPP ED UNIT
BOOTHBAY REGION EA (AOS 98)
BREWER EA
BREWER NON TEACHING ASSN
BRISTOL EA (AOS 93)
BROOKLIN EA
BRUNSWICK EA
CALAIS EA (INCLUDES ROBINSTON)
CAPE ELIZABETH EA
CARRABEC EA
CARRABEC ESP
CASWELL EA
CENTRAL AROOSTOOK TA (SAD 42)
CENTRAL LINCOLN (DAMARISCOTTA)
CHARLOTTE EA
CHERRYFIELD SCHOOL TA
COASTAL EA
COMMUNITY COLLEGE ADMIN
COMMUNITY COLLEGE FACULTY
CSD 13 ESP ASSN
CUTLER-MACHIASPORT-WHITING TA
TOWN OF CUTLER (SSEA)
DAMARISCOTTA AREA TA (AOS 93)
DAYTON EA
DOWN EAST EA (RSU 24)
DOWNEAST ESP (RSU 24)
DOWNEAST TA (UNION 107)
EAST GRAND EA - SAD 14
EAST GRAND SUPPORT STAFF ASSN
EAST MACHIAS EA
EAST MILLINOCKETT TA
EAST RANGE II CSD
EASTERN AROOSTOOK EA RSU 39
EASTON TA
EASTPORT TA (UNION 104)
EDUCATION ASSOCIATION BY THE BAY
FALMOUTH EA
FALMOUTH BUS DRIVERS, CUSTODIANS,
&MAINTENANCE WORKERS ASSN
FAYETTE EA
FORT FAIRFIELD TA
FOX ISLAND TA
FOXCROFT ACADEMY
FRENCHBORO (FINN’S)
FRYEBURG ACADEMY
GARDINER TA ( RSU 11)
GARDINER BUS DRIVERS (RSU 11)
GEORGE STEVENS ACADEMY TA
GEORGETOWN TA
MISC DISTRICT 9
GLENBURN EA
GORHAM EA
GORHAM ESPA
GRAY-NEW GLOUCESTER TA
GRAY-NEW GLOUCESTER ESP ASSN
GREENBUSH TA
GREENVILLE EA (UNION 60)
HARMONY EA
HERMON TA
HOPE TA
INDIAN TOWNSHIP/PLEASANT POINT
EA
ISLESBORO TA
ISLAND TA (DEER ISLE-STONINGTON
CSD)
JACKMAN TA
JEFFERSON SSA (AOS 93) (SUPPORT
STAFF)
JEFFERSON TA (AOS 93)
JONESBORO TA (UNION 102)
KENNEBUNK, ARUNDEL,
KENNEBUNKPORT EA
KENNEBEC INTRA DISTRICT SCHOOLS
(KIDS EA - RSU 2)
KITTERY EA
LAKE REGION TA (SAD 61)
LAKE REGION ESP ASSN (SAD 61)
LAKE REGION NON-TEACHING
EMPLOYEE ASSN (SAD 61)
LEWISTON EA
LEWISTON FOOD SERVICE MANAGERS
ASSN
LINCOLNVILLE EA
LISBON EA
LORING EA
LUBEC EA
LUBEC ED SUPPORT STAFF ASSN
MACHIAS EA
MACHIAS ESP
MADAWASKA EA
MADISON AREA EA
MARANACOOK AREA STAFF
ASSOCIATION (RSU 38)
MASSABESIC EA (SAD 57)
MAINE VOCATIONAL REGION 7
MAINE VOCATIONAL REGION 10 TA
MEDOMAK VALLEY EA
MEDWAY TA (UNION 113)
MEGUNTICOOK TA (SAD 28)
MEGUNTICOOK ESP
MERRYMEETING TA
MERRYMEETING EMPLOYESS ASSN
(SUPPORT STAFF CONTRACT)
MILFORD EA
MILLINOCKET EA
MOOSABEC TA
MPBN EA
M.S.A.D. #35 SUPPORT EDUCATIONAL
UNIT MEA/NEA
MT ABRAM TA (RSU 58)
MT BLUE EA (RSD 9)
MT DESERT ELEMENTARY TA
MT DESERT ISLAND REGIONAL HIGH
SCHOOL TA
NEW SWEDEN/UNION 122 TA
NOBLEBORO TA (AOS 93)
NORTHERN AROOSTOOK TA
NORTHERN PENOBSCOT TECH
ORRINGTON TA
OXFORD HILLS TA (SAD 17)
OXFORD HILLS EDUCATIONAL SUPPORT
PERSONNEL ASSN
PEMBROKE EA
PEMETIC TA
PENOBSCOT BAY TA
PENOBSCOT VALLEY EA (UN 31)
PEQUAWKET VALLEY TA (SAD 72)
PEQUAWKET VALLEY SUPPORT STAFF
ASSN
PERRY TA
PIONEER TA (SAD 30)
PORTLAND EA
PORTLAND PUBLIC LIBRARY STAFF
ASSN
QUAMPHEGAN EA IN M.S.A.D. 35
RANGELEY TA (RSU 78)
RANGELEY SUPPORT STAFF
ASSOCIATION (RSU 78)
RAYMOND WINDHAM ESPA
REGION TWO OF APPLIED TECH
REGION 03 EA REG VOC ED
REG 04 EA - UNITED TECH CENTER
REGION 08 EA
REGION 10 TEACHERS ASSN
REGION 11 TA
RIVERSIDE EA RSU 26
ROBBINSTON/CALAIS EA
RSU 4 EA
RSU #16 EA
RSU 18 EA
RSU 21 EDUCATIONAL TECHNICIAN
ASSOCIATION
RSU 23 EA
RSU #34 EA
RSU 50 EA
RSU 58 ESP ASSN
RSU #67 EA
RSU 73 EA
SACO EA
SAD 01 TA - PRESQUE ISLE
SAD 03 EA
SAD 04 TA - GUILFORD
SAD 06 SACO VALLEY TA
SAD 06 ISPA SACO VALLEY
SAD 06 SUPPORT STAFF
SAD 09 - MT BLUE RSU EA
SAD 23/RSU 87 (CARMEL)
SAD 29 TA - HOULTON
SAD 30 TA - LEE (PIONEER TA)
SAD 33 EA (ST. AGATHA)
SAD 37 TA - HARRINGTON
SAD 41 EA MILO
SAD 46 EA - DEXTER
SAD 49 TA - FAIRFIELD
SAD 49 ESP ASSN
SAD 49 ED TECH I
SAD 51 EA - CUMBERLAND
SAD 53 EA - PITTSFIELD
SAD 55 TRI-COUNTY TA
SAD 54 EA - SKOWHEGAN
SAD 60 SUPPORT (BERWICK)
SAD 60 TA - BERWICK
SAD #63 TA
SAD 64 CORINTH TA
SAD 68 DOVER-FOXCROFT
SAD 70 EA - HODGDON
SAD 70 ED SUPPORT ASSN
SAGADAHOC EA
SANFORD TA
SANFORD CUSTODIANS
SANFORD ADMINISTRATORS
SCARBOROUGH EA
SEACOAST EA
SEAM MISC
SEAM - UM - PRESQUE ISLE
SEAM - UM - FARMINGTON
SEAM - USM
SEAM - ST. JOSEPH’S COLLEGE
SEAM - THOMAS COLLEGE
SEAM - LEW-AUB COLLEGE
SEAM - UNE
SEAM - UM - ORONO
SEAM - COLLEGE OF THE ATLANTIC
SEAM - UM - MACHIAS
SEAM - BOWDOIN COLLEGE
SEAM - HUSSON COLLEGE
SEBAGO EAST SHORE EA
SEDGWICK EA
SHEEPSCOT VALLEY EA
SOUTH PORTLAND TA
SOUTH PORTLAND - ESPA
SOUTH PORTLAND SCHOOL DEPT SEA
SOUTH BRISTOL (AOS 93)
SOUTHWEST HARBOR SCHOOL DEPT
STRATTON EA (EUSTIS)
TELSTAR EA (SAD 44)
THORNTON ACADEMY TA
TREMONT TA
TRI-TOWN EA
TRI 22 EA (HAMPDEN)
UMPSA
UNION 44 PROF ASST
URVTA - TRENTON
UNION 108 TA (VANCEBORO)
UNION 122 TA (WOODLAND)
UPPER KENNEBEC VALLEY EA
VAN BUREN EA
VASSALBORO EA
VEAZIE EA
WALDO COUNTY TECH CENTER
WASHBURN TA
WASHINGTON ACADEMY TA
WATERVILLE EA
WELLS-OGUNQUIT TA
WELLS-OGUNQUIT SUPPORT STAFF
ASSN
WESTBROOK EA
WESTERN FOOTHILLS EA (RSU 10)
WINSLOW EA
WINTHROP EA
WOODLAND EA (BAILEYVILLE)
YARMOUTH EA
YORK ESP
YORK TA
IF YOU HAVE FURTHER
QUESTIONS ABOUT YOUR
LOCAL PLEASE CONTACT
THE MAINE EDUCATION
ASSOCIATION AT
1-888-622-4418