Membership Application
Moraine Valley Community College Annuitant Association
(Please print, complete, and mail to address listed with a
check for your dues)
_______________________________________________________
· Eligibility: Membership is open to all members of the State Universities Retirement System (SURS) including current faculty-staff, annuitants, their spouses and survivors.
Gift Memberships: Members may select to pay the membership dues for a new member by completing the application and returning to Steven P. Lebre. Annual renewal of such membership gift will be based on the the benefactor and/or recipient of such membership gift.
· Questions: Call Steven P. Lebre (Treasurer, MVCCAA) at 1.815.485.7217 or Email: lebres910@yahoo.com
·
Complete the following application form and mail with your check (in the amount
of $26.00 to MVCCAA: $21 to SUAA and $5 to MVCCAA) to c/o Steven P. Lebre, MVCC Annuitants Association,
303 S. Pine St., New Lenox, IL 60451
------------------------ Cut or separate at this line------------------------------------
Membership
Application: Moraine
Valley Community College Annuitants Association
Telephone ( _____)
____ - _____________
Email address: ____________________________________
New Membership (____) Renewal
(_____), For ___08-09, ___09-10, ____
SUAA
will mail you a dues
renewal notification 10-12 months following the month you paid your initial dues
(e.g., if you became a new member - or rejoined - in Mar 05, you will receive a
renewal notice Jan 06); and thereafter based on your anniversary month). Paid
members as of 31 Dec 04 will remain in the annual June renewal cycle, and
received their dues renewal notification in mid-April yearly.
Gift Membership paid by ________________________________________
NOTE: Click HERE
if you wish to select the SURS dues deduction
option: An authorization form must be completed, signed, and returned with this
application.
Return to the MVCCAA Home Page