RPEA Membership Form

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Spouses and Survivors of Retired Public Employees may join the RPEA as an Associate member.

Include a submember in your membership registration

Regular Member - 1 Year

Regular Member - 2 Year

Regular Member - 5 Year

Regular Member - Lifetime

Associate Member - 1 Year

Associate Member - 2 Year

Associate Member - 5 Year

Associate Member - Lifetime

I would like to automatically renew my membership when it expires.

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First Name *

Last Name *

Email *

Primary Phone Number *

Secondary Phone Number

Address Line 1 *

Address Line 2

City *

State/Province *

Zip/Postal Code *

Country

Spouse's Name

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Date Joined: If blank, enter today's date. *

Use MM/DD/YYYY format

Are you retired from one of the Alaska Retirement Systems? *

Yes

Alaska Retirement System(s)

PERS

TRS

JRS

NGNMRS

EPORS

None of the above (Associate Member)

Former Work Region

Current Residence Region

Receive Email Newsletters?

Yes, I would like to receive RPEA newsletters by email

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Include a submember

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Choose Existing Contact(s)

Membership Level *

I would like to automatically renew my membership when it expires.

First Name *

Last Name *

Address Line 1

Address Line 2

City

State/Province

Zip/Postal Code

Country

Add {{subMemberDisplayName}}

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Discount Code

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Order summary

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Discounts -{{formatAmount(orderSummary.discounts)}}

Total {{formatAmount(orderSummary.total)}}

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Card

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Cardholder First Name *

Cardholder Last Name *

Cardholder Email

Card *

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Address Line 1

Address Line 2

City