Forms
TRTA/GPRSP MEMBERSHIP ENROLLMENT FORM
2018-2019
New member______ Renewing member _____
Name____________________________________ Date of birth___/___/___
Address________________________________________________________
City________________________ State_______ Zip_____________
Phone___________________________ Email_________________________
School(s) where I worked in GPISD ________________________________________________
I did not work in GPISD. I worked in _______________________________________________
I receive an annuity from a teacher retirement system. ___Yes ___No
TRTA/GPRSP membership year is July 1, 2017 – June 30, 2018.
Membership dues are not tax-deductible.
State dues: $35.00 Local dues: $10.00 Total: $45.00
If you are paying both state and local dues, you may pay cash ($45.00) or make your check ($45.00) payable to GPRSP. The treasurer will be responsible for sending your dues to state.
If mailing your dues (checks payable to TRTA/GPRSP only), please send to:
Grand Prairie Retired School Personnel
PO Box 530344
Grand Prairie, TX 75053
Payment options:
#1____I am a TRTA Diamond member, and/or my state dues are payroll deducted. I am paying local dues only ($10). _____Cash or ____Check #________
#2____I am paying state and local dues ($45) in Cash or Check #_________.
#3____I have sent state dues into TRTA. I am paying local dues ($10) only.
_____Cash or _____Check #_________