ContractEarly Enrollment Membership Agreement • April 12th, 2017
1Ethnic Group: Ethnic minority information is optional, and failure to provide it will in no way affect your membership status, rights or benefits in LEA, NSEA or NEA. The information will be kept confidential. This data is collected to ensure ethnic minority guarantees in the governance of the Association.
Lincoln Education Association, Nebraska State Education Association, National Education Association 4920 Normal Blvd., Lincoln NE 68506 * (402) 489-7500 * www.lincolneducationassociation.orgEarly Enrollment Membership Agreement • April 12th, 2017
Name Local Association: Lincoln Education Association Last 4 Digits - Social Security Number Employer Name: Lincoln Public Schools Date of Birth LPS Employee ID# Address Building Name City State Zip LPS Phone LPS E-Mail Home Phone Hire Date (Your 1st Paid Contract Day) Cell Phone Text?7 Yes No Were you a member in 2016-2017? Yes No Personal E-Mail If yes, indicate the Local Association
