Automatic Payroll Deduction Form

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Authorization Form

As a convenience to our members, this form allows your membership fee to be automatically deducted from your payroll check.

For Professional Memberships:

Deductions are currently $15 per month when paid on a 12-month schedule, and $18 per month when paid on a 10-month schedule.

For Support Memberships:

Deductions are currently $7.50 per month when paid on a 12-month schedule, and $9.00 per month when paid on a 10-month schedule.

Please complete the form below. Your information will not be processed until the Submit button is clicked. Required fields are marked with an *.

Name*
First Middle Initial Last
Email*
School*
School District*
Employee ID #*

If ID # is unknown, please enter 00.
Authorization*
I accept the terms listed below.*
I authorize the School Board to deduct association dues from my paycheck, and to remit this amount to Virginia Professional Educators.
I understand that it is necessary every four or five years to raise these dues by $1 a month, and I approve these general increases to my deduction.
I understand that I will be notified in advance of any such increase in membership cost, and given the opportunity to make any changes to my membership status or payment options.
This authority is to remain in effect until I notify VPE and the School Board in writing that I wish to cease these deductions.
Digital Signature*
Name
This field is for validation purposes and should be left unchanged.