Membership Application

To become a member of East Mid-Michigan MEA-Retired Region 12, please print off and mail the completed application with a check for $5 (payable to East Mid-Michigan MEA-Retired) to:

509 Vance Road Midland, MI 48640.



Application:

Last Name:

First Name:

E-mail address:

Address:

Telephone No. - -

City:

Check the following: Working Retired

State: Zip: Year retired:

District of last Employment:

 

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